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The relationship between neutrophil-to-lymphocyte ratio and cerebral collateral circulation in patients with symptomatic severe intracranial artery stenosis or occlusion

  • Yao Li
    Affiliations
    Department of Neurology, Hebei General Hospital, Shijiazhuang, China

    Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, China
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  • Dongxia An
    Affiliations
    Department of Neurointervention, Beijing Fengtai Youanmen Hospital, Beijing, China

    Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, China
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  • Xiaohua Xie
    Affiliations
    Department of Neurology, Hebei General Hospital, Shijiazhuang, China

    Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, China
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  • Yanhong Dong
    Correspondence
    Corresponding author at: No. 348, Heping West Road, Xinhua District, Shijiazhuang, Hebei Province, China.
    Affiliations
    Department of Neurology, Hebei General Hospital, Shijiazhuang, China

    Hebei Provincial Key Laboratory of Cerebral Networks and Cognitive Disorders, China
    Search for articles by this author

      Highlights

      • ASITN/SIR scoring of the intracranial collateral circulation was performed in all patients by the gold standard DSA technique.
      • Neutrophil/lymphocyte ratio (NLR) may be associated with collateral circulation through inflammatory response and atherosclerosis.
      • We suggest that NLR levels correlate with the development of cerebral collateral circulation in patients with symptomatic severe stenosis or occlusion of intracranial arteries.

      Abstract

      Background

      The neutrophil/lymphocyte ratio (NLR) has been considered a prognostic indicator for determining the systemic inflammatory response and atherosclerosis. We aimed to determine the relationship between NLR and the development of cerebral collateral circulation in patients with symptomatic severe stenosis or occlusion of intracranial arteries.

      Methods

      All patients underwent digital subtraction angiography (DSA) within 14 days of admission and were divided into a group with good collateral circulation (77 patients) and a group with poor collateral circulation (86 patients) according to the DSA collateral compensation grading method. Apo B, total cholesterol, LDL, and Neutrophil count in the poor side branch group were significantly higher than in the good side branch group. Multifactorial analysis showed that high NLR levels were a valid predictor of poor collateral circulation in patients with symptomatic severe intracranial artery stenosis or occlusion. Spearman correlation analysis showed that the size of the collateral branch score was negatively correlated with NLR (r = −0.509, P < 0.001) and cholesterol content (r = −0.249, P = 0.002). NLR predicted poor collateral circulation with an AUC of 0.620 (sensitivity 66.7 %, specificity 61.3 %, 95 % CI = 0.517–0.723,P < 0.05).

      Conclusion

      We demonstrate a correlation between NLR levels and the development of collateral circulation in the brain in patients with symptomatic severe stenosis or occlusion of the intracranial arteries.

      Keywords

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