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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
Neutrophil counts, neutrophil ratio, and new stroke in minor ischemic stroke or TIA
Bihong Zhu1, Yuesong Pan1, Jing Jing1
1From the Department of Neurology (B.Z., Y.P., J.J., X.M., X.Z., L.L., H.L., Yilong Wang, Yongjun Wang), Beijing Tiantan Hospital, Capital Medical University; Taizhou First People's Hospital (B.Z., Z.W.), Zhejiang; China National Clinical Research Center for Neurological Diseases (B.Z., Y.P., J.J., X.M., X.Z., L.L., H.L., Yilong Wang, Yongjun Wang); Center of Stroke (B.Z., Y.P., J.J., X.M., X.Z., L.L., H.L., Yilong Wang, Yongjun Wang), Beijing Institute for Brain Disorders; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease (B.Z., Y.P., J.J., X.M., X.Z., L.L., H.L., Yilong Wang, Yongjun Wang), China; INI Stroke Network (D.W.), OSF Healthcare System, University of Illinois College of Medicine, Peoria; and Dell Medical School (S.C.J.), University of Texas at Austin.
Objective:
Evidence about whether neutrophil counts or neutrophil ratio is associated with new stroke is scant. The aim of this study is to assess the association of neutrophil counts or neutrophil ratio with a new stroke in patients with minor stroke or TIA.
Methods:
We derived data from the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorized into 4 groups according to the quartile of neutrophil counts or neutrophil ratio. The primary outcome was a new stroke (ischemic or hemorrhagic), and secondary outcomes included a new composite vascular event (stroke, myocardial infarction, or death resulting from cardiovascular causes) and ischemic stroke during the 90-day follow-up. We assessed the association between neutrophil counts, neutrophil ratio, and risk of new stroke.
Results:
A total of 4,854 participants were enrolled, among whom 495 had new strokes at 90 days. Compared with the first quartile, the second, third, and fourth quartiles of neutrophil counts were associated with increased risk of new stroke (adjusted hazard ratio 1.40 [95% confidence interval (CI) 1.05-1.87], 1.55 [95% CI 1.17-2.05], and 1.69 [95% CI 1.28-2.23], respectively, p for trend <0.001). Similar results were observed for the endpoint of composite events and ischemic stroke. Parallel results were found for neutrophil ratio.
Conclusion:
High levels of both neutrophil counts and neutrophil ratio were associated with an increased risk of new stroke, composite events, and ischemic stroke in patients with a minor ischemic stroke or TIA.
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