El riesgo de inflamación residual se asocia con deterioro cognitivo después de un accidente cerebrovascular isquémico agudo

Acute ischemic stroke (AIS) may lead to varying degrees of cognitive impairment, while the inflammatory response plays a significant role in this process. This study aims to examine the relationship between residual inflammation risk (RIR) and the development of post-stroke cognitive impairment (PSCI) in patients with acute ischemic stroke.

This prospective cohort study enrolled a total of 172 patients diagnosed with AIS over the study period from January 2024 to December 2024. They were divided into four groups: RIR only [low-density lipoprotein cholesterol (LDL-C) < 2.6 mmol/L and high-sensitivity CRP (hsCRP) ≥ 2 mg/L], residual cholesterol risk (RCR) only (LDL-C ≥ 2.6 mmol/L and hsCRP < 2 mg/L), both risk or residual cholesterol and inflammatory risk (RCIR) (LDL-C ≥ 2.6 mmol/L and hsCRP ≥ 2 mg/L), and neither risk (LDL-C < 2.6mmol/L and hsCRP < 2 mg/L). PSCI is defined as a Montreal Cognitive Assessment (MoCA) score below 22 at 6 months after stroke. The final analysis included 172 patients who completed the follow-up. The association between RIR and PSCI was analyzed by multivariable logistic regression analyses.

Among the 172 enrolled patients, 58 (33.7%) developed PSCI. The proportion of patients with neither risk, RIR, RCR, and RCIR was 23.8% (n=41),18.6% (n=32), 32.0% (n=55) and 25.6% (n=44), respectively. Compared to those without PSCI, patients with PSCI had a higher prevalence of hyperlipidemia (P = 0.026), a greater proportion of RIR (P = 0.015), and higher white blood cell count (P = 0.042) and neutrophil count (P = 0.016). Logistic regression analysis, adjusting for major confounding factors, identified RIR as an independent factor associated with PSCI occurrence (OR 4.496, 95% CI 1.571-17.477, P = 0.030; RCIR: OR 7.357, 95% CI 2.081-26.006, P = 0.002).

This study presents what is, to our knowledge, the first evidence that RIR is associated with PSCI among acute ischemic stroke patients.