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Updated: Oct 28, 2025
Stereological and Flow Cytometry Characterization of Leukocyte Subpopulations in Models of Transient or Permanent Cerebral Ischemia
Published on: December 28, 2014
Leukocyte subtypes and adverse clinical outcomes in patients with acute ischemic cerebrovascular events
Anxin Wang1,2, Kehua Quan1,2, Xue Tian1,2
1China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Insights
Different white blood cell subtypes impact outcomes after ischemic stroke and TIA. Higher neutrophils and monocytes increase risk, while lymphocytes and eosinophils may offer protection, aiding outcome prediction.
Area of Science:
- Neurology
- Hematology
- Clinical Research
Background:
- Investigating the prognostic significance of leukocyte subtypes in acute ischemic cerebrovascular events.
- Examining associations with adverse clinical outcomes like death, recurrent stroke, and poor functional status.
Purpose of the Study:
- To determine if leukocyte subtype effects on adverse outcomes differ in patients with ischemic stroke and transient ischemic attack (TIA).
- To assess the incremental predictive value of leukocyte subtypes beyond conventional risk factors.
Main Methods:
- Utilized data from the Third China National Stroke Registry (CNSR-III) including 14,174 patients.
- Analyzed leukocyte subtype counts and percentages within 24 hours of admission, using quartile-based risk assessments.
- Calculated hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs), and employed C statistics, IDI, and NRI for predictive value evaluation.
Main Results:
- Elevated risks of adverse outcomes were linked to higher counts of leukocytes, neutrophils, and monocytes.
- Conversely, increased lymphocyte and eosinophil counts correlated with reduced risks.
- Basophil counts showed no significant correlation with adverse outcomes, though percentages of subtypes were also associated with outcomes.
Conclusions:
- Leukocyte subtypes exhibit distinct relationships with 3-month and 1-year adverse clinical outcomes in acute ischemic cerebrovascular events.
- These subtypes offer a slight improvement in predictive value when added to conventional risk models.
Background:
Our study aimed to evaluate whether the effects on adverse clinical outcomes, defined as death, recurrent stroke, and poor functional outcomes, differed by leukocyte subtype in patients with acute ischemic cerebrovascular events, including both ischemic stroke and transient ischemic attack (TIA).
Methods:
We derived data from the Third China National Stroke Registry (CNSR-III). The counts and percentages of each leukocyte subtype were collected within the first 24 hours after admission. Enrolled patients were classified into four groups by the quartiles of each leukocyte subtype count or percentage. Hazard ratios (HRs) or odds ratios (ORs) and their 95% confidence intervals (CIs) of adverse clinical outcomes were calculated, with the lowest quartile group as the reference category. We used C statistics, integrated discrimination improvement (IDI), and the net reclassification index (NRI) to evaluate each leukocyte subtype's incremental predictive value beyond conventional risk factors.
Results:
A total of 14,174 patients were enrolled. Higher counts of leukocytes, neutrophils, and monocytes were associated with elevated risks of adverse clinical outcomes. In contrast, higher counts of lymphocytes and eosinophils were related to reduced risks of adverse clinical outcomes. Meanwhile, basophil counts seemed to not correlate with adverse clinical outcomes. Furthermore, there were also significant associations between the percentages of leukocyte subtypes and adverse clinical outcomes.
Conclusions:
Leukocyte subtypes had different relationships with adverse clinical outcomes at 3-month and 1-year follow-up in patients with acute ischemic cerebrovascular events and could slightly increase the predictive value compared with the conventional model.
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