机构：[1]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China[2]Department of Neurology, Taizhou First People’s Hospital, Zhejiang, China[3]Department of Neurology and Suzhou Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Jiangsu, China[4]China National Clinical Research Center for Neurological Diseases, Beijing[5]Center of Stroke, Beijing Institute for Brain Disorders, China[6]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China[7]Illinois Neurological Institute Stroke Network, Sisters of the Third Order of St. Francis Healthcare System, University of Illinois College of Medicine, Peoria[8]Dell Medical School, University of Texas at Austin
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.
基金：
This study is supported by grants from the Ministry of Science and
Technology of the People’s Republic of China (2016YFC0901001,
2016YFC0901002, 2017YFC1310901, 2018YFC1311700 and 2018
YFC1311706), grants from Beijing Municipal Science and Technology
Commission (Z15110200390000 and Z151100003915117), and
grants from Beijing Municipal Commission of Health and Family
Planning (No.2016-1-2041 and SML20150502).
第一作者机构：[1]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, China[2]Department of Neurology, Taizhou First People’s Hospital, Zhejiang, China[4]China National Clinical Research Center for Neurological Diseases, Beijing[5]Center of Stroke, Beijing Institute for Brain Disorders, China[6]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, China
共同第一作者：
通讯作者：
通讯机构：[*1]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6 Tiantanxili, Dongcheng District, Beijing 100050, China,
推荐引用方式(GB/T 7714)：
Bihong Zhu,Huihui Liu,Yuesong Pan,et al.Elevated Neutrophil and Presence of Intracranial Artery Stenosis Increase the Risk of Recurrent Stroke[J].STROKE.2018,49(10):2294-2300.doi:10.1161/STROKEAHA.118.022126.
APA：
Bihong Zhu,Huihui Liu,Yuesong Pan,Jing Jing,Hao Li...&Yongjun Wang.(2018).Elevated Neutrophil and Presence of Intracranial Artery Stenosis Increase the Risk of Recurrent Stroke.STROKE,49,(10)
MLA：
Bihong Zhu,et al."Elevated Neutrophil and Presence of Intracranial Artery Stenosis Increase the Risk of Recurrent Stroke".STROKE 49..10(2018):2294-2300
医学