Associations of neutrophil-to-lymphocyte ratio with intracranial and extracranial atherosclerotic stenosis

Abstract

BackgroundNeutrophil-to-lymphocyte ratio (NLR) has been shown to be an important inflammatory maker. This study aims to investigate the association of NLR with intracranial and extracranial atherosclerotic stenosis.MethodsWe retrospectively recruited patients who underwent digital subtraction angiography (DSA) for evaluating intracranial/extracranial stenosis in the Zhongnan Hospital of Wuhan University from January 2017 to October 2021. Clinical characteristics, DSA data, blood routine, and lipid profile were recorded. Logistic regression was used to evaluate the association of NLR and intercranial/extracranial atherosclerotic stenosis in three aspects: distribution of stenosis, whether the stenosis is symptomatic, and degree of stenosis.ResultsA total of 1,129 patients were included in our analysis, with a median age of 62 y (interquartile range 55–68), and a median admission NLR of 2.39 (interquartile range 1.84–3.42). A total of 986 patients presented intracranial and/or extracranial atherosclerotic stenosis. Increased NLR were associated with intracranial stenosis [odds ratio (OR), 1.54; 95% CI, 1.27–1.85; p < 0.001], extracranial stenosis (OR, 1.56; 95% CI, 1.25–1.96; p < 0.001), and combined intracranial/extracranial stenosis (OR, 1.61; 95% CI, 1.28–2.03; p < 0.001). After adjustment of potential factors, higher NLR were independently associated with symptomatic stenosis (OR, 1.16; 95% CI, 1.05–1.27; p = 0.003) and degree of stenosis (OR, 1.32; 95% CI, 1.17–1.49; p < 0.001). Compared with the first quartile NLR, the second, third, and fourth quartiles NLR were independent risk factors for symptomatic stenosis and stenosis degree (both p for trend <0.001).ConclusionIncreased NLR is an important factor associated with both intracranial and extracranial atherosclerotic stenosis. Patients with symptomatic intracranial/extracranial atherosclerotic stenosis or a more severe degree of stenosis presented elevated NLR levels.

Risk Factors and Clinical Characteristics of First-ever Ischemic Stroke Caused by ICAS with Leukoaraiosis

“…Clinically, HsCRP is more sensitive than CRP and is closely associated with cerebral small vessel disease 35 . NLR and CHR, as novel inflammatory ratios, correlate pro-inflammatory, pro-endothelial cell injury, and pro-sclerotic plaque formation of inflammatory responsive cells with anti-inflammatory and antioxidant, inhibition of cell activation migration and anti-atherosclerosis of HDL-C, presumably to better reflect LA 36 - 37 . CAR as an integrated biomarker reflects the systemic inflammatory response and nutritional status with higher sensitivity, and the synergistic relationship between the two provides a more accurate reflection of the actual organism 38 .…”

Association between triglyceride-glucose index and intracranial/extracranial atherosclerotic stenosis: findings from a retrospective study

“…This retrospective clinical research was conducted at a single center. Patient selection, clinical/imaging data collection and analysis process has been published previously [11].…”