Dan Hu1, Caixia Ding2, Xuemei Jiang2, Jing Xiao2, Chuanyou Li2, Lankun Zhang2, Tingting Li2, Yun Ji2, Yuan Peng3, Xun Luo4, Lei Sheng2, Qingmei Wang5, Haoxin Wu6. 1. School of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China; Department of Neurology, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China. 2. Department of Neurology, The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China. 3. Department of Rehabilitation Medicine, Guangzhou First People's Hospital, Guangzhou, Guangdong, China. 4. Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China; Kerry Rehabilitation Medicine Research Institute, Shenzhen, China. 5. Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Boston, MA, United States. Electronic address: wang.qingmei@mgh.harvard.edu. 6. School of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China. Electronic address: wuhaoxin@sohu.com.
Abstract
OBJECTIVES: Inflammation is associated with the occurrence and prognosis of ischemic stroke. The aim of this study was to evaluate the association between inflammatory biomarkers and the short-term clinical outcomes of acute ischemic stroke (AIS) patients after intravenous thrombolysis (IVT). MATERIALS AND METHODS: A total of 208 AIS patients treated with IVT were enrolled in this retrospective study. Blood tests of inflammatory biomarkers, including the leukocyte count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio and high-sensitivity C-reactive protein level, were conducted within 24 h after IVT. The primary outcome was decent functional recovery (DFR) [modified Rankin Scale score (mRS) of 0-2] at 3 months. The secondary outcomes included symptomatic intracranial hemorrhage and 3-month mortality. A multivariate analysis was performed to evaluate the associations between inflammatory biomarkers and 3-month clinical outcomes. RESULTS: At 3 months follow-up, 113 (62.2%) patients achieved DFR. As compared to patients with DFR, patients without DFR had higher leukocyte counts (8.5 ± 2.4 × 109/L versus 6.9 ± 1.7 × 109/L, P=0.000), neutrophil counts (6.1 ± 2.3 × 109/L versus 4.6±1.7 × 109/L, P=0.000) and neutrophil-to-lymphocyte ratio (4.6 ± 2.4 versus 3.3 ± 1.9, P=0.000). After adjusting for the stroke subtype, severity of stroke, and medical history, the leukocyte count and neutrophil count remained significantly correlated with non-DFR (adjusted odds ratio [OR] 1.488; 95% confidence interval [CI], 1.247-1.776; P=0.000 and adjusted OR 1.522; 95% CI, 1.269-1.826; P=0.000, respectively). CONCLUSIONS: This study demonstrates that increased levels of inflammatory biomarkers are independently associated with poor outcomes at 3 months in AIS patients treated with IVT.
OBJECTIVES:Inflammation is associated with the occurrence and prognosis of ischemic stroke. The aim of this study was to evaluate the association between inflammatory biomarkers and the short-term clinical outcomes of acute ischemic stroke (AIS) patients after intravenous thrombolysis (IVT). MATERIALS AND METHODS: A total of 208 AISpatients treated with IVT were enrolled in this retrospective study. Blood tests of inflammatory biomarkers, including the leukocyte count, neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio and high-sensitivity C-reactive protein level, were conducted within 24 h after IVT. The primary outcome was decent functional recovery (DFR) [modified Rankin Scale score (mRS) of 0-2] at 3 months. The secondary outcomes included symptomatic intracranial hemorrhage and 3-month mortality. A multivariate analysis was performed to evaluate the associations between inflammatory biomarkers and 3-month clinical outcomes. RESULTS: At 3 months follow-up, 113 (62.2%) patients achieved DFR. As compared to patients with DFR, patients without DFR had higher leukocyte counts (8.5 ± 2.4 × 109/L versus 6.9 ± 1.7 × 109/L, P=0.000), neutrophil counts (6.1 ± 2.3 × 109/L versus 4.6±1.7 × 109/L, P=0.000) and neutrophil-to-lymphocyte ratio (4.6 ± 2.4 versus 3.3 ± 1.9, P=0.000). After adjusting for the stroke subtype, severity of stroke, and medical history, the leukocyte count and neutrophil count remained significantly correlated with non-DFR (adjusted odds ratio [OR] 1.488; 95% confidence interval [CI], 1.247-1.776; P=0.000 and adjusted OR 1.522; 95% CI, 1.269-1.826; P=0.000, respectively). CONCLUSIONS: This study demonstrates that increased levels of inflammatory biomarkers are independently associated with poor outcomes at 3 months in AISpatients treated with IVT.