A Score of Low-Grade Inflammation for Predicting Stroke Recurrence in Patients with Ischemic Stroke

Min Wu,1,&ast; Xiaohao Zhang,2,&ast; Jingjing Chen,3,&ast; Mingming Zha,4 Kang Yuan,5 Kangmo Huang,2 Yi Xie,2 Jianzhong Xue,6 Xinfeng Liu1,2,7 1Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, 210002, People’s Republi...

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Autores principales:	Wu M, Zhang X, Chen J, Zha M, Yuan K, Huang K, Xie Y, Xue J, Liu X
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	low-grade inflammation stroke recurrence ischemic stroke predictor Pathology RB1-214 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/bc3c3ac28a364d1fb28afab0c858077f
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id	oai:doaj.org-article:bc3c3ac28a364d1fb28afab0c858077f
record_format	dspace
institution	DOAJ
collection	DOAJ
language	EN
topic	low-grade inflammation stroke recurrence ischemic stroke predictor Pathology RB1-214 Therapeutics. Pharmacology RM1-950
spellingShingle	low-grade inflammation stroke recurrence ischemic stroke predictor Pathology RB1-214 Therapeutics. Pharmacology RM1-950 Wu M Zhang X Chen J Zha M Yuan K Huang K Xie Y Xue J Liu X A Score of Low-Grade Inflammation for Predicting Stroke Recurrence in Patients with Ischemic Stroke
description	Min Wu,1,&ast; Xiaohao Zhang,2,&ast; Jingjing Chen,3,&ast; Mingming Zha,4 Kang Yuan,5 Kangmo Huang,2 Yi Xie,2 Jianzhong Xue,6 Xinfeng Liu1,2,7 1Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, 210002, People’s Republic of China; 2Department of Neurology, Jinling Hospital, Affiliated Medical School of Nanjing University, Nanjing, 210002, People’s Republic of China; 3Department of Neurology, Changhai Hospital, Navy Medical University, Shanghai, 200433, People’s Republic of China; 4Department of Neurology, Jinling Hospital, Medical School of Southeast University, Nanjing, 210002, People’s Republic of China; 5Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, 210000, People’s Republic of China; 6Department of Neurology, Changshu No.2 People’s Hospital, Changshu, People’s Republic of China; 7Stroke Center & Department of Neurology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xinfeng LiuDepartment of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, No. 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, People’s Republic of ChinaTel +86 138 13835114Email xfliu2@vip.163.comJianzhong XueDepartment of Neurology, Changshu No.2 People’s Hospital, No. 18 Taishan Road, Changshu, Jiangsu Province, People’s Republic of ChinaTel +86 13506247572Email xjz2021@sina.comBackground and Purpose: The impact of low-grade inflammation (LGI) on stroke recurrence has not been well studied yet. We aimed to evaluate the association between LGI and stroke recurrence in patients with ischemic stroke.Methods: Patients with first-ever ischemic stroke diagnosed within 72 hours of symptoms onset were consecutively recruited from the Nanjing Stroke Registry Program. C-reactive protein (CRP) level, white blood cell (WBC) count, platelet (PLT) count, and neutrophil-to-lymphocyte ratio (NLR) were conceived as low-grade inflammation biomarkers and combined into a standardized LGI score. The association of LGI score with the risk of stroke recurrence was analyzed with multivariate Cox regression models. Analyses accounting for the competing risk of stroke recurrence and death were also performed.Results: Of the 1214 patients studied (median age, 61 years; male, 71.6%), 177 (14.6%) patients experienced a recurrent stroke with a median follow-up of 23.0 (interquartile ranges, 14.5– 34.0) months. Patients with stroke recurrence had a higher LGI score (median, 3 versus − 2; P < 0.001) than those without recurrence. The univariate analysis indicated that patients with LGI scores in the fourth quartile were more likely to have a stroke recurrence (hazard ratios [HR], 4.312; 95% confidence interval [CI], 2.675– 6.952; P < 0.001). After adjusting for potential confounders, the association remained significant in the multivariate Cox regression model (HR, 4.080; 95% CI, 2.420– 6.879; P < 0.001). Competing risks model and sensitivity analysis further confirmed this conclusion.Conclusion: This study showed that an elevated LGI score was associated with a higher risk of stroke recurrence, independent of other vascular risk factors.Keywords: low-grade inflammation, stroke recurrence, ischemic stroke, predictor
format	article
author	Wu M Zhang X Chen J Zha M Yuan K Huang K Xie Y Xue J Liu X
author_facet	Wu M Zhang X Chen J Zha M Yuan K Huang K Xie Y Xue J Liu X
author_sort	Wu M
title	A Score of Low-Grade Inflammation for Predicting Stroke Recurrence in Patients with Ischemic Stroke
title_short	A Score of Low-Grade Inflammation for Predicting Stroke Recurrence in Patients with Ischemic Stroke
title_full	A Score of Low-Grade Inflammation for Predicting Stroke Recurrence in Patients with Ischemic Stroke
title_fullStr	A Score of Low-Grade Inflammation for Predicting Stroke Recurrence in Patients with Ischemic Stroke
title_full_unstemmed	A Score of Low-Grade Inflammation for Predicting Stroke Recurrence in Patients with Ischemic Stroke
title_sort	score of low-grade inflammation for predicting stroke recurrence in patients with ischemic stroke
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/bc3c3ac28a364d1fb28afab0c858077f
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spelling	oai:doaj.org-article:bc3c3ac28a364d1fb28afab0c858077f2021-12-02T19:12:38ZA Score of Low-Grade Inflammation for Predicting Stroke Recurrence in Patients with Ischemic Stroke1178-7031https://doaj.org/article/bc3c3ac28a364d1fb28afab0c858077f2021-09-01T00:00:00Zhttps://www.dovepress.com/a-score-of-low-grade-inflammation-for-predicting-stroke-recurrence-in--peer-reviewed-fulltext-article-JIRhttps://doaj.org/toc/1178-7031Min Wu,1,&ast; Xiaohao Zhang,2,&ast; Jingjing Chen,3,&ast; Mingming Zha,4 Kang Yuan,5 Kangmo Huang,2 Yi Xie,2 Jianzhong Xue,6 Xinfeng Liu1,2,7 1Department of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, Nanjing, 210002, People’s Republic of China; 2Department of Neurology, Jinling Hospital, Affiliated Medical School of Nanjing University, Nanjing, 210002, People’s Republic of China; 3Department of Neurology, Changhai Hospital, Navy Medical University, Shanghai, 200433, People’s Republic of China; 4Department of Neurology, Jinling Hospital, Medical School of Southeast University, Nanjing, 210002, People’s Republic of China; 5Department of Neurology, Jinling Hospital, Nanjing Medical University, Nanjing, 210000, People’s Republic of China; 6Department of Neurology, Changshu No.2 People’s Hospital, Changshu, People’s Republic of China; 7Stroke Center & Department of Neurology, the First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xinfeng LiuDepartment of Neurology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University, No. 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, People’s Republic of ChinaTel +86 138 13835114Email xfliu2@vip.163.comJianzhong XueDepartment of Neurology, Changshu No.2 People’s Hospital, No. 18 Taishan Road, Changshu, Jiangsu Province, People’s Republic of ChinaTel +86 13506247572Email xjz2021@sina.comBackground and Purpose: The impact of low-grade inflammation (LGI) on stroke recurrence has not been well studied yet. We aimed to evaluate the association between LGI and stroke recurrence in patients with ischemic stroke.Methods: Patients with first-ever ischemic stroke diagnosed within 72 hours of symptoms onset were consecutively recruited from the Nanjing Stroke Registry Program. C-reactive protein (CRP) level, white blood cell (WBC) count, platelet (PLT) count, and neutrophil-to-lymphocyte ratio (NLR) were conceived as low-grade inflammation biomarkers and combined into a standardized LGI score. The association of LGI score with the risk of stroke recurrence was analyzed with multivariate Cox regression models. Analyses accounting for the competing risk of stroke recurrence and death were also performed.Results: Of the 1214 patients studied (median age, 61 years; male, 71.6%), 177 (14.6%) patients experienced a recurrent stroke with a median follow-up of 23.0 (interquartile ranges, 14.5– 34.0) months. Patients with stroke recurrence had a higher LGI score (median, 3 versus − 2; P < 0.001) than those without recurrence. The univariate analysis indicated that patients with LGI scores in the fourth quartile were more likely to have a stroke recurrence (hazard ratios [HR], 4.312; 95% confidence interval [CI], 2.675– 6.952; P < 0.001). After adjusting for potential confounders, the association remained significant in the multivariate Cox regression model (HR, 4.080; 95% CI, 2.420– 6.879; P < 0.001). Competing risks model and sensitivity analysis further confirmed this conclusion.Conclusion: This study showed that an elevated LGI score was associated with a higher risk of stroke recurrence, independent of other vascular risk factors.Keywords: low-grade inflammation, stroke recurrence, ischemic stroke, predictorWu MZhang XChen JZha MYuan KHuang KXie YXue JLiu XDove Medical Pressarticlelow-grade inflammationstroke recurrenceischemic strokepredictorPathologyRB1-214Therapeutics. PharmacologyRM1-950ENJournal of Inflammation Research, Vol Volume 14, Pp 4605-4614 (2021)

A Score of Low-Grade Inflammation for Predicting Stroke Recurrence in Patients with Ischemic Stroke

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