Research Article
BibTex RIS Cite
Year 2023, Volume: 9 Issue: 5 - September 2023, 1207 - 1214, 04.09.2023
https://doi.org/10.18621/eurj.1341008

Abstract

References

  • 1. Kernan WN. Stroke after transient ischaemic attack: dealing in futures. Lancet 2007;369:251-2.
  • 2. Wardlaw JM, Brazzelli M, Chappell FM, Miranda H, Shuler K, Sandercock PA, et al. ABCD2 score and secondary stroke prevention: meta-analysis and effect per 1,000 patients triaged. Neurology 2015;85:373-80.
  • 3. Sanders LM, Srikanth VK, Blacker DJ, Jolley DJ, Cooper KA, Phan TG. Performance of the ABCD2 score for stroke risk post TIA: meta-analysis and probability modeling. Neurology 2012;79:971-80.
  • 4. Ildstad F, Ellekjær H, Wethal T, Lydersen S, Fjærtoft H, Indredavik B. ABCD3-I and ABCD2 scores in a TIA population with low stroke risk. Stroke Res Treat 2021;2021:8845898.
  • 5. Molnar T, Papp V, Banati M, Szereday L, Pusch G, Szapary L, et al. Relationship between C-reactive protein and early activation of leukocytes indicated by leukocyte anti sedimentation rate (LAR) in patients with acute cerebrovascular events. Clin Hemorheol and Microcirc 2010;44:183-92.
  • 6. Wang N, Yang Y, Qiu B, Gao Y, Wang A, Xu Q, et al. Correlation of the systemic immune-inflammation index with short- and long-term prognosis after acute ischemic stroke. Aging 2022;14:6567-78.
  • 7. Wei C, Tian W, Xia X, Li X. Neutrophil to lymphocyte ratio predicts early stroke risk after transient ischemic attack. Int J Cerebrovasc Dis 2019;12:332-6.
  • 8. Wei CJ, Xue JJ, Zhou X, Xia XS, Li X. Systemic immune-inflammation index is a prognostic predictor for patients with acute ischemic stroke treated with intravenous thrombolysis. Neurologist 2023 Jun 27. doi: 10.1097/NRL.0000000000000508.
  • 9. Perry JJ, Sharma M, Sivilotti ML, Sutherland J, Symington C, Worster A, et al. Prospective validation of the ABCD2 score for patients in the emergency department with transient ischemic attack. CMAJ 2011;183:1137-45.
  • 10. Dahlquist RT, Young JM, Reyner K, Farzad A, Moleno RB, Gandham G, et al. Initiation of the ABCD3-I algorithm for expediated evaluation of transient ischemic attack patients in an emergency department. Am J Emerg Med 2020;38:741-5.
  • 11. Syrjanen J, Teppo AM, Valtonen VV, Iivanainen M, Maury CPJ. Acute phase response in cerebral infarction. J Clin Pathol 1989;42:63-8.
  • 12. Petrovic-Djergovic D, Goonewardena SN, Pinsky DJ. Inflammatory disequilibrium in stroke. Circ Res 2016;119:142-58.
  • 13. Jickling GC, Liu D, Ander BP, Stamova B, Zhan X, Sharp FR. Targeting neutrophils in ischemic stroke: translational insights from experimental studies. J Cereb Blood Flow Metab 2015;35:888-901.
  • 14. Buck BH, Liebeskind DS, Saver JL, Bang OY, Yun SW, Starkman S, et al. Early neutrophilia is associated with volume of ischemic tissue in acute stroke. Stroke 2008;39:355-60.
  • 15. Ross AM, Hurn P, Perrin N, Wood L, Carlini W, Potempa K: Evidence of the peripheral inflammatory response in patients with transient ischemic attack. J Stroke Cerebrovasc Dis 2007;16:203-7.
  • 16. Gökhan S, Ozhasenekler A, Durgun HM, Akil E, Ustündag M, Orak M: Neutrophil lymphocyte ratios in stroke subtypes and transient ischemic attack. Eur Rev Med Pharmacol Sci 2013;17:653-7.
  • 17. Cavrak ME, Hass R, Stephens RJ, Adcock A, Petrone AB. Leukocyte biomarkers for the differential diagnosis of mild acute ischemic stroke, transient ischemic attack, and stroke mimic. Cureus 2021;13:13383.
  • 18. Liu Y, Li G, Jia J, Liu X, Guo J, Zhao X. Clinical significance of neutrophil to lymphocyte ratio in ischemic stroke and transient ischemic attack in young adults. BMC Neurol 2022;22:481.
  • 19. Hou D, Wang C, Luo Y, Ye X, Han X, Feng Y, et al. Systemic immune-inflammation index (SII) but not platelet-albumin-bilirubin (PALBI) grade is associated with severity of acute ischemic stroke (AIS). Int J Neurosci 2021;131:1203-8.
  • 20. Li LH, Chen CT, Chang YC, Chen YJ, Lee IH, How CK. Prognostic role of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index in acute ischemic stroke: A STROBE-compliant retrospective study. Medicine (Baltimore) 2021;100:e26354.
  • 21. Acar BA, Acar T, Vatan MB, Aras YG, Ulaş SB, Eryılmaz HA, et al. Predictive value of systemic immune-inflammation index for cerebral reperfusion and clinical outcomes in patients with acute ischemic stroke undergoing endovascular treatment. Eur Rev Med Pharmacol Sci 2022;26:5718-28.
  • 22. Huang L. Increased systemic immune-inflammation index predicts disease severity and functional outcome in acute ischemic stroke patients. Neurologist 2023;28:32-8.
  • 23. Zhou YX, Li WC, Xia SH, Xiang T, Tang C, Luo JL, et al. Predictive value of the systemic immune inflammation index for adverse outcomes in patients with acute ischemic stroke. Front Neurol 2022;13:836595.
  • 24. Adiguzel A, Arsava EM, Topcuoglu MA. Temporal course of peripheral inflammation markers and indexes following acute ischemic stroke: prediction of mortality, functional outcome, and stroke-associated pneumonia. Neurol Res 2022;44:224-31.
  • 25. Purroy F, Montaner J, Molina CA, Delgado P, Arenillas JF, Chacon P, et al. C-reactive protein predicts further ischemic events in transient ischemic attack patients. Acta Neurol Scand 2007;115:60-6.
  • 26. Mengozzi M, Kirkham FA, Girdwood EER, Bunting E, Drazich E, Timeyin J, et al. C-reactive protein predicts further ischemic events in patients with transient ischemic attack or lacunar stroke. Front Immunol 2020;11:1403.
  • 27. Di Castelnuovo A, Agnoli C, de Curtis A, Giurdanella MC, Sieri S, Mattiello A, et al. Elevated levels of D-dimers increase the risk of ischaemic and haemorrhagic stroke. Findings from the EPICOR Study. Thromb Haemost 2014:112;941-6.
  • 28. Folsom AR, Gottesman RF, Appiah D, Shahar E, Mosley TH. Plasma D-dimer and incident ischemic stroke and coronary heart disease: the atherosclerosis risk in communities study. Stroke 2016;47:18-23.
  • 29. Zakai NA, Olson NC, Judd SE, Kleindorfer DO, Kissela BM, Howard G, et al. Haemostasis biomarkers and risk of intracerebral haemorrhage in the REasons for Geographic and Racial Differences in Stroke Study. Thromb Haemost 2017;117:1808-15.
  • 30. Robson SC, Shephard EG, Kirsch RE. Fibrin degradation product D-dimer induces the synthesis and release of biologically active IL-1 beta, IL-6 and plasminogen activator inhibitors from monocytes in vitro. Br J Haematol 1994;86:322-6.

Predictive role of ABCD2, ABCD3I, C-reactive protein, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammation index in 90-day and long-term stroke after transient ischemic attack

Year 2023, Volume: 9 Issue: 5 - September 2023, 1207 - 1214, 04.09.2023
https://doi.org/10.18621/eurj.1341008

Abstract

Objectives: Transient ischemic attack (TIA) is a neurological emergency and a precursor of ischemic stroke. ABCD2 and ABCD3I scores predict stroke after TIA, and clinicians use preclinical, clinical, and radiological parameters for calculating these scores. Our study aimed to investigate the efficacy of peripheral blood markers in predicting 90-day and long-term stroke risk after TIA.

Methods: This retrospective study was conducted in Kastamonu Training and Research Hospital between January 2015 and November 2022. The demographic data of 99 patients who applied with the diagnosis of TIA and peripheral blood markers at the time of first admission to the hospital were used in the study. These parameters was evaluated in 90-day and long-term (>12 months) stroke after TIAs.

Results: Of the 99 patients in our study, 59% (n = 58) were male. The mean age of the patients was 70 ± 13 years. ABCD2 (age, blood pressure, clinical features, duration of symptoms, and presence of diabetes mellitus) and ABCD3I (age, blood pressure, clinical features, duration of symptoms, presence of diabetes mellitus, dual TIA, and ipsilatheral carotis stenosis) scores and C-reactive protein (CRP) were statistically significant in predicting 90-day stroke. ABCD2 and ABCD3I were not effective in predicting long-term stroke. In addition, CRP, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) parameters were statistically significant in long-term stroke. CRP (AUC=793, sensitivity=82%, and specificity=81%) values were higher than ABCD2 (AUC=779, sensitivity=73%, and specificity=76%) and ABCD3I (AUC=755, sensitivity=82%, and specificity=70%) scores in predicting 90-day stroke.

Conclusions: Our study showed that ABCD2, ABCD3I, and CRP effectively predict 90-day stroke after TIA. Furthermore, CRP was more effective than ABCD2 and ABCD3I scores in predicting 90-day stroke after TIA. CRP, NLR, PLR, and SII also effectively predicted long-term stroke after TIA.

References

  • 1. Kernan WN. Stroke after transient ischaemic attack: dealing in futures. Lancet 2007;369:251-2.
  • 2. Wardlaw JM, Brazzelli M, Chappell FM, Miranda H, Shuler K, Sandercock PA, et al. ABCD2 score and secondary stroke prevention: meta-analysis and effect per 1,000 patients triaged. Neurology 2015;85:373-80.
  • 3. Sanders LM, Srikanth VK, Blacker DJ, Jolley DJ, Cooper KA, Phan TG. Performance of the ABCD2 score for stroke risk post TIA: meta-analysis and probability modeling. Neurology 2012;79:971-80.
  • 4. Ildstad F, Ellekjær H, Wethal T, Lydersen S, Fjærtoft H, Indredavik B. ABCD3-I and ABCD2 scores in a TIA population with low stroke risk. Stroke Res Treat 2021;2021:8845898.
  • 5. Molnar T, Papp V, Banati M, Szereday L, Pusch G, Szapary L, et al. Relationship between C-reactive protein and early activation of leukocytes indicated by leukocyte anti sedimentation rate (LAR) in patients with acute cerebrovascular events. Clin Hemorheol and Microcirc 2010;44:183-92.
  • 6. Wang N, Yang Y, Qiu B, Gao Y, Wang A, Xu Q, et al. Correlation of the systemic immune-inflammation index with short- and long-term prognosis after acute ischemic stroke. Aging 2022;14:6567-78.
  • 7. Wei C, Tian W, Xia X, Li X. Neutrophil to lymphocyte ratio predicts early stroke risk after transient ischemic attack. Int J Cerebrovasc Dis 2019;12:332-6.
  • 8. Wei CJ, Xue JJ, Zhou X, Xia XS, Li X. Systemic immune-inflammation index is a prognostic predictor for patients with acute ischemic stroke treated with intravenous thrombolysis. Neurologist 2023 Jun 27. doi: 10.1097/NRL.0000000000000508.
  • 9. Perry JJ, Sharma M, Sivilotti ML, Sutherland J, Symington C, Worster A, et al. Prospective validation of the ABCD2 score for patients in the emergency department with transient ischemic attack. CMAJ 2011;183:1137-45.
  • 10. Dahlquist RT, Young JM, Reyner K, Farzad A, Moleno RB, Gandham G, et al. Initiation of the ABCD3-I algorithm for expediated evaluation of transient ischemic attack patients in an emergency department. Am J Emerg Med 2020;38:741-5.
  • 11. Syrjanen J, Teppo AM, Valtonen VV, Iivanainen M, Maury CPJ. Acute phase response in cerebral infarction. J Clin Pathol 1989;42:63-8.
  • 12. Petrovic-Djergovic D, Goonewardena SN, Pinsky DJ. Inflammatory disequilibrium in stroke. Circ Res 2016;119:142-58.
  • 13. Jickling GC, Liu D, Ander BP, Stamova B, Zhan X, Sharp FR. Targeting neutrophils in ischemic stroke: translational insights from experimental studies. J Cereb Blood Flow Metab 2015;35:888-901.
  • 14. Buck BH, Liebeskind DS, Saver JL, Bang OY, Yun SW, Starkman S, et al. Early neutrophilia is associated with volume of ischemic tissue in acute stroke. Stroke 2008;39:355-60.
  • 15. Ross AM, Hurn P, Perrin N, Wood L, Carlini W, Potempa K: Evidence of the peripheral inflammatory response in patients with transient ischemic attack. J Stroke Cerebrovasc Dis 2007;16:203-7.
  • 16. Gökhan S, Ozhasenekler A, Durgun HM, Akil E, Ustündag M, Orak M: Neutrophil lymphocyte ratios in stroke subtypes and transient ischemic attack. Eur Rev Med Pharmacol Sci 2013;17:653-7.
  • 17. Cavrak ME, Hass R, Stephens RJ, Adcock A, Petrone AB. Leukocyte biomarkers for the differential diagnosis of mild acute ischemic stroke, transient ischemic attack, and stroke mimic. Cureus 2021;13:13383.
  • 18. Liu Y, Li G, Jia J, Liu X, Guo J, Zhao X. Clinical significance of neutrophil to lymphocyte ratio in ischemic stroke and transient ischemic attack in young adults. BMC Neurol 2022;22:481.
  • 19. Hou D, Wang C, Luo Y, Ye X, Han X, Feng Y, et al. Systemic immune-inflammation index (SII) but not platelet-albumin-bilirubin (PALBI) grade is associated with severity of acute ischemic stroke (AIS). Int J Neurosci 2021;131:1203-8.
  • 20. Li LH, Chen CT, Chang YC, Chen YJ, Lee IH, How CK. Prognostic role of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index in acute ischemic stroke: A STROBE-compliant retrospective study. Medicine (Baltimore) 2021;100:e26354.
  • 21. Acar BA, Acar T, Vatan MB, Aras YG, Ulaş SB, Eryılmaz HA, et al. Predictive value of systemic immune-inflammation index for cerebral reperfusion and clinical outcomes in patients with acute ischemic stroke undergoing endovascular treatment. Eur Rev Med Pharmacol Sci 2022;26:5718-28.
  • 22. Huang L. Increased systemic immune-inflammation index predicts disease severity and functional outcome in acute ischemic stroke patients. Neurologist 2023;28:32-8.
  • 23. Zhou YX, Li WC, Xia SH, Xiang T, Tang C, Luo JL, et al. Predictive value of the systemic immune inflammation index for adverse outcomes in patients with acute ischemic stroke. Front Neurol 2022;13:836595.
  • 24. Adiguzel A, Arsava EM, Topcuoglu MA. Temporal course of peripheral inflammation markers and indexes following acute ischemic stroke: prediction of mortality, functional outcome, and stroke-associated pneumonia. Neurol Res 2022;44:224-31.
  • 25. Purroy F, Montaner J, Molina CA, Delgado P, Arenillas JF, Chacon P, et al. C-reactive protein predicts further ischemic events in transient ischemic attack patients. Acta Neurol Scand 2007;115:60-6.
  • 26. Mengozzi M, Kirkham FA, Girdwood EER, Bunting E, Drazich E, Timeyin J, et al. C-reactive protein predicts further ischemic events in patients with transient ischemic attack or lacunar stroke. Front Immunol 2020;11:1403.
  • 27. Di Castelnuovo A, Agnoli C, de Curtis A, Giurdanella MC, Sieri S, Mattiello A, et al. Elevated levels of D-dimers increase the risk of ischaemic and haemorrhagic stroke. Findings from the EPICOR Study. Thromb Haemost 2014:112;941-6.
  • 28. Folsom AR, Gottesman RF, Appiah D, Shahar E, Mosley TH. Plasma D-dimer and incident ischemic stroke and coronary heart disease: the atherosclerosis risk in communities study. Stroke 2016;47:18-23.
  • 29. Zakai NA, Olson NC, Judd SE, Kleindorfer DO, Kissela BM, Howard G, et al. Haemostasis biomarkers and risk of intracerebral haemorrhage in the REasons for Geographic and Racial Differences in Stroke Study. Thromb Haemost 2017;117:1808-15.
  • 30. Robson SC, Shephard EG, Kirsch RE. Fibrin degradation product D-dimer induces the synthesis and release of biologically active IL-1 beta, IL-6 and plasminogen activator inhibitors from monocytes in vitro. Br J Haematol 1994;86:322-6.
There are 30 citations in total.

Details

Primary Language English
Subjects Neurology and Neuromuscular Diseases
Journal Section Original Articles
Authors

İdris Kocatürk 0000-0002-3415-6906

Sedat Gülten 0000-0001-5134-1620

Early Pub Date August 25, 2023
Publication Date September 4, 2023
Submission Date August 10, 2023
Acceptance Date August 23, 2023
Published in Issue Year 2023 Volume: 9 Issue: 5 - September 2023

Cite

AMA Kocatürk İ, Gülten S. Predictive role of ABCD2, ABCD3I, C-reactive protein, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and systemic immune-inflammation index in 90-day and long-term stroke after transient ischemic attack. Eur Res J. September 2023;9(5):1207-1214. doi:10.18621/eurj.1341008

e-ISSN: 2149-3189 


The European Research Journal, hosted by Turkish JournalPark ACADEMIC, is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

by-nc-nd.png

2024