Elevated Neutrophil and Presence of Intracranial Artery Stenosis Increase the Risk of Recurrent Stroke.
Document Type
Article
Abstract
Background and Purpose- The association of neutrophil and intracranial artery stenosis (ICAS) with the prognosis of stroke is uncertain. This study evaluated the relationship between neutrophil levels with and without ICAS and the prognosis of patients with minor stroke or transient ischemic attack. Methods- Data from the CHANCE trial (Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events) was reviewed. Patients were divided into 4 groups according to the dichotomy of neutrophil counts and status of ICAS. The primary outcome was a new stroke (ischemic or hemorrhagic), and secondary outcomes included a new composite vascular event (stroke, myocardial infarction, or cardiovascular death) and ischemic stroke. Safety outcome was any hemorrhage at 90 days. The association between neutrophil counts with and without ICAS and risk of any outcome was analyzed by Cox regression models. Results- Of 1034 patients included in this subgroup analysis, 91 had recurrent strokes. Compared with the lower neutrophil levels without ICAS, higher neutrophil levels with ICAS significantly increased the risk of stroke recurrence (adjusted hazard ratio, 2.26; 95% CI, 1.19-4.31; P=0.01) and composite outcome (adjusted hazard ratio, 1.98; 95% CI, 1.06-3.67; P=0.03). However, there was no safety issue. Conclusions- Concomitant presence of higher neutrophil levels and ICAS was associated with the increased risk of stroke recurrence, and combined adverse outcome events in patients already had minor ischemic stroke or high-risk transient ischemic attack. Clinical Trial Registration- URL: https://www.clinicaltrials.gov . Unique identifier: NCT00979589.
Medical Subject Headings
Aged; Cerebral Infarction; Clopidogrel; Constriction, Pathologic; Drug Therapy, Combination; Female; Hemorrhage; Humans; Male; Middle Aged; Neutrophils; Platelet Aggregation Inhibitors; Recurrence; Risk Factors; Stroke
Publication Date
10-1-2018
Publication Title
Stroke; a journal of cerebral circulation
ISSN
1524-4628
Volume
49
Issue
10
First Page
2294
Last Page
2300
PubMed ID
30355101
Digital Object Identifier (DOI)
10.1161/STROKEAHA.118.022126
Recommended Citation
Zhu, Bihong; Liu, Huihui; Pan, Yuesong; Jing, Jing; Li, Hao; Zhao, Xingquan; Liu, Liping; Wang, David Z.; Johnston, S Claiborne; Wang, Zhimin; Wang, Yilong; and Wang, Yongjun, "Elevated Neutrophil and Presence of Intracranial Artery Stenosis Increase the Risk of Recurrent Stroke." (2018). Neurology. 1857.
https://scholar.barrowneuro.org/neurology/1857