Association of platelet-to-white blood cell ratio and platelet-to-neutrophil ratio with the risk of fatal stroke occurrence in middle-aged to older Chinese

Abstract

Background White blood cell (WBC) and neutrophil (NEUT) counts, which are commonly inflammatory markers, have been related to an increased risk of fatal stroke. However, it is unclear whether platelet-to-white blood cell ratio (PWR) and platelet-to-neutrophil ratio (PNR) are related to the risk of fatal stroke in middle-aged to older populations. Method In total, 27,811 participants without a stroke history at baseline were included and followed up for a mean of 14.3 years (standard deviation = 3.2), and 838 stroke deaths were recorded. The Cox proportional hazards regression was used to assess the relationships between the PWR and the PNR and the risk of fatal strokes. Results Compared to the 1st quartile, an increased risk of fatal all stroke showed among the participants in the highest quartiles of both the WBC (adjusted hazard ratio (aHR) = 1.35, 95% confidence interval (CI) 1.09–1.66) and the NEUT (aHR = 1.45, 95% CI 1.18–1.79). The restricted cubic splines showed decreased trends in associations of the PWR and the PNR with the risk of fatal all stroke. A decreased risk of fatal all stroke showed in those with the highest quartiles for both the PWR (aHR = 0.73, 95% CI 0.53–1.00) and the PNR (aHR = 0.74, 95% CI 0.54–1.01). The participants with the 2nd, the 3rd and the 4th change quartiles for the PWR and the PNR had weak decreasing trends for the risk of fatal all stroke, compared to those in the 1st change quartile, and the significant associations were observed in those with an increase of 20% for the PWR with the risk of fatal haemarragic stroke (aHR = 0.47, 95% CI 0.22–0.95) and a decrease of 20% for the PNR with the risk of fatal all stroke (aHR = 1.33, 95% CI 0.99–1.79), compared to those with stable dynamic changes. Conclusions Higher neutrophil count and platelet-to-neutrophil ratio were associated with a contrary risk of fatal stroke, with an increased for the former and a decreased for the later. A potentially chronic inflammation should be paid close attention to stroke occurrence in relatively healthy middle-aged to older populations.

Elevated Levels of Neutrophil-to Monocyte Ratio Are Associated with the Initiation of Paroxysmal Documented Atrial Fibrillation in the First Two Months after Heart Transplantation: A Uni-Institutional Retrospective Study

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Systematically analysis of decompensated cirrhotic patients with spontaneous bacterial peritonitis to identify diagnostic and prognostic indexes

“…Neutrophil count is a sensitive index that re ects in ammation in the body. The combination of neutrophils with other indices has proven critical in diagnosing or predicting multiple diseases such as platelets to neutrophils ratio in a stroke [21],…”

Clinical utility of haematological inflammatory biomarkers in predicting 30‐day mortality in hospitalised adult patients with COVID‐19

“…The PLT‐to‐white blood cell (WBC) ratio (PWR) had been linked to mortality risk in patients with acute events such as acute on top of chronic hepatic failure, acute ischaemic stroke and infective endocarditis 12 …”

“…9 The PLT-to-white blood cell (WBC) ratio (PWR) had been linked to mortality risk in patients with acute events such as acute on top of chronic hepatic failure, acute ischaemic stroke and infective endocarditis. 12 The red blood cell (RBC) distribution width (RDW), as well as coefficient of variation of RDW (RDW-CV or RCDW) and RDW standard deviation (RDW-SD), are a measure of the range of variation of RBC volume rather than the diameter of the cells through studying the volume curve and are provided as part of a FBC evaluation. 13 The mechanism of a RDW-mortality correlation is linked to inflammation.…”