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Current Neurovascular Research

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ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

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Research Article

Pan-Immune-Inflammatory Value Predicts the 3 Months Outcome in Acute Ischemic Stroke Patients after Intravenous Thrombolysis

Author(s): Shan Wang, Lulu Zhang, Huan Qi, Lulu Zhang(F), Qi Fang* and Lanfeng Qiu*

Volume 20, Issue 4, 2023

Published on: 25 October, 2023

Page: [464 - 471] Pages: 8

DOI: 10.2174/0115672026276427231024045957

open access plus

Abstract

Background and Purpose: Immune and inflammatory response plays a central role in the clinical outcomes of stroke. This study is aimed to explore the clinical significance of the new inflammation index named pan-immune-inflammation value (PIV) in patients with acute ischemic stroke (AIS) after intravenous thrombolysis therapy (IVT).

Methods: Data were collected from 717 patients who received IVT at the First Affiliated Hospital of Soochow University. Baseline data were collected before intravenous thrombolysis. Multivariate logistic regression analysis was used to assess the association between PIV and 3 months clinical outcome after intravenous thrombolysis. We also used receiver operating characteristic (ROC) curves analysis to assess the discriminative ability of PIV, platelet to lymphocyte ratio (PLR), neutrophil to lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) in predicting 3 months poor outcome.

Results: Of 717 patients, 182 (25.4%) patients had poor outcomes at 3 months. Patients with 3 months of poor outcome had significantly higher PIV levels compared to those with favorable outcomes [316.32 (187.42-585.67) vs. 223.80 (131.76-394.97), p < 0.001)]. After adjusting for potential confounders, the risk of 3 months of poor outcome was significantly higher among patients whose PIV fell in the third quartile (244.21-434.49) and the fourth quartile (> 434.49) than those in the first quartile (< 139.93) (OR = 1.905, 95% CI: 1.040-3.489; OR = 2.229, 95%CI: 1.229-4.044). The area under the ROC curve of PIV to predict 3 months of poor outcome was 0.607 (95%CI: 0.560-0.654; p < 0.001). The optimal cut-off values of PIV were 283.84 (59% sensitivity and 62% specificity).

Conclusion: The higher levels of PIV were independently associated with 3 months of poor outcomes in AIS patients receiving IVT. PIV like other inflammatory factors (PLR, NLR, and SII), can also predict adverse outcomes after IVT in AIS patients.

Keywords: Pan-immune-inflammation value, acute ischemic stroke, intravenous thrombolysis, clinical outcome, multivariate logistic regression analysis, new inflammation index.

« Previous Next »
[1]
Feigin VL, Stark BA, Johnson CO. et al.Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol 2021; 20(10): 795-820.
[http://dx.doi.org/10.1016/S1474-4422(21)00252-0] [PMID: 34487721]
[2]
Feigin VL, Norrving B, Mensah GA. Global burden of stroke. Circ Res 2017; 120(3): 439-48.
[http://dx.doi.org/10.1161/CIRCRESAHA.116.308413] [PMID: 28154096]
[3]
Endres M, Moro MA, Nolte CH, Dames C, Buckwalter MS, Meisel A. Immune pathways in etiology, acute phase, and chronic sequelae of ischemic stroke. Circ Res 2022; 130(8): 1167-86.
[http://dx.doi.org/10.1161/CIRCRESAHA.121.319994] [PMID: 35420915]
[4]
Weng Y, Zeng T, Huang H. et al.Systemic immune-inflammation index predicts 3-month functional outcome in acute ischemic stroke patients treated with intravenous thrombolysis. Clin Interv Aging 2021; 16: 877-86.
[http://dx.doi.org/10.2147/CIA.S311047] [PMID: 34040364]
[5]
Gong P, Liu Y, Gong Y. et al.The association of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and lymphocyte to monocyte ratio with post-thrombolysis early neurological outcomes in patients with acute ischemic stroke. J Neuroinflammation 2021; 18(1): 51.
[http://dx.doi.org/10.1186/s12974-021-02090-6] [PMID: 33610168]
[6]
Fucà G, Guarini V, Antoniotti C. et al.The pan-immune-inflammation value is a new prognostic biomarker in metastatic colorectal cancer: Results from a pooled-analysis of the valentino and TRIBE first-line trials. Br J Cancer 2020; 123(3): 403-9.
[http://dx.doi.org/10.1038/s41416-020-0894-7] [PMID: 32424148]
[7]
Murat B, Murat S, Ozgeyik M, Bilgin M. Comparison of pan‐immune‐inflammation value with other inflammation markers of long‐term survival after ST ‐segment elevation myocardial infarction. Eur J Clin Invest 2023; 53(1): e13872.
[http://dx.doi.org/10.1111/eci.13872] [PMID: 36097823]
[8]
Tong X, Wang C, Liao X. et al.Smoking–thrombolysis relationship depends on ischemic stroke subtype. Stroke 2016; 47(7): 1811-6.
[http://dx.doi.org/10.1161/STROKEAHA.116.013124] [PMID: 27222526]
[9]
Zhong C, Lv L, Liu C. et al.High homocysteine and blood pressure related to poor outcome of acute ischemia stroke in Chinese population. PLoS One 2014; 9(9): e107498.
[http://dx.doi.org/10.1371/journal.pone.0107498] [PMID: 25265507]
[10]
Wang Y, Cui L, Ji X. et al.The China National Stroke Registry for patients with acute cerebrovascular events: design, rationale, and baseline patient characteristics. Int J Stroke 2011; 6(4): 355-61.
[http://dx.doi.org/10.1111/j.1747-4949.2011.00584.x] [PMID: 21609414]
[11]
Luo Y, Jin H, Guo ZN. et al.Effect of hyperhomocysteinemia on clinical outcome and hemorrhagic transformation after thrombolysis in ischemic stroke patients. Front Neurol 2019; 10: 592.
[http://dx.doi.org/10.3389/fneur.2019.00592] [PMID: 31249548]
[12]
Kopin L, Lowenstein CJ. Dyslipidemia. Ann Intern Med 2017; 167(11): ITC81-96.
[http://dx.doi.org/10.7326/AITC201712050] [PMID: 29204622]
[13]
DeLong JH, Ohashi SN, O’Connor KC, Sansing LH. Inflammatory responses after ischemic stroke. Semin Immunopathol 2022; 44(5): 625-48.
[http://dx.doi.org/10.1007/s00281-022-00943-7] [PMID: 35767089]
[14]
Wu F, Liu Z, Zhou L. et al.Systemic immune responses after ischemic stroke: From the center to the periphery. Front Immunol 2022; 13: 911661.
[http://dx.doi.org/10.3389/fimmu.2022.911661] [PMID: 36211352]
[15]
Tian X, Wang P, Chen S. et al.Association of serum uric acid to lymphocyte ratio, a novel inflammatory biomarker, with risk of stroke: A prospective cohort study. CNS Neurosci Ther 2023; 29(4): 1168-77.
[http://dx.doi.org/10.1111/cns.14094] [PMID: 36650955]
[16]
Zhang XG, Xue J, Yang WH. et al.Inflammatory markers as independent predictors for stroke outcomes. Brain Behav 2021; 11(1): e01922.
[http://dx.doi.org/10.1002/brb3.1922] [PMID: 33314753]
[17]
Liu YL, Wu ZQ, Qu JF. et al.High neutrophil‐to‐lymphocyte ratio is a predictor of poor short‐term outcome in patients with mild acute ischemic stroke receiving intravenous thrombolysis. Brain Behav 2020; 10(12): e01857.
[http://dx.doi.org/10.1002/brb3.1857] [PMID: 32981201]
[18]
Wang N, Yang Y, Qiu B. et al.Correlation of the systemic immune-inflammation index with short- and long-term prognosis after acute ischemic stroke. Aging 2022; 14(16): 6567-78.
[http://dx.doi.org/10.18632/aging.204228] [PMID: 35985678]
[19]
Xu JH, He XW, Li Q. et al.Higher platelet-to-lymphocyte ratio is associated with worse outcomes after intravenous thrombolysis in acute ischaemic stroke. Front Neurol 2019; 10: 1192.
[http://dx.doi.org/10.3389/fneur.2019.01192] [PMID: 31798520]
[20]
Guven DC, Sahin TK, Erul E, Kilickap S, Gambichler T, Aksoy S. The association between the pan-immune-inflammation value and cancer prognosis: A systematic review and meta-analysis. Cancers 2022; 14(11): 2675.
[http://dx.doi.org/10.3390/cancers14112675] [PMID: 35681656]
[21]
Ministrini S, Carbone F, Montecucco F. Updating concepts on atherosclerotic inflammation: From pathophysiology to treatment. Eur J Clin Invest 2021; 51(5): e13467.
[http://dx.doi.org/10.1111/eci.13467] [PMID: 33259635]
[22]
Cao X, Zhu Q, Xia X. et al.The correlation between novel peripheral blood cell ratios and 90-day mortality in patients with acute ischemic stroke. PLoS One 2020; 15(8): e0238312.
[http://dx.doi.org/10.1371/journal.pone.0238312] [PMID: 32857820]
[23]
Chen Y, Ren J, Yang N. et al.Eosinophil-to-monocyte ratio is a potential predictor of prognosis in acute ischemic stroke patients after intravenous thrombolysis. Clin Interv Aging 2021; 16: 853-62.
[http://dx.doi.org/10.2147/CIA.S309923] [PMID: 34040362]
[24]
Sun YY, Wang MQ, Wang Y. et al.Platelet-to-lymphocyte ratio at 24h after thrombolysis is a prognostic marker in acute ischemic stroke patients. Front Immunol 2022; 13: 1000626.
[http://dx.doi.org/10.3389/fimmu.2022.1000626] [PMID: 36225933]
[25]
Meng J, Zhang J, Fang J. et al.Dynamic inflammatory changes of the neurovascular units after ischemic stroke. Brain Res Bull 2022; 190: 140-51.
[http://dx.doi.org/10.1016/j.brainresbull.2022.10.003] [PMID: 36220523]
[26]
Wang J, Jiang Y, Zeng D, Zhou W, Hong X. Prognostic value of plasma HMGB1 in ischemic stroke patients with cerebral ischemia-reperfusion injury after intravenous thrombolysis. J Stroke Cerebrovasc Dis 2020; 29(9): 105055.
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.105055] [PMID: 32807461]
[27]
Chen H, Luan X, Zhao K. et al.The association between neutrophil-to-lymphocyte ratio and post-stroke depression. Clin Chim Acta 2018; 486: 298-302.
[http://dx.doi.org/10.1016/j.cca.2018.08.026] [PMID: 30130533]
[28]
Huang G, Chen H, Wang Q. et al.High platelet-to-lymphocyte ratio are associated with post-stroke depression. J Affect Disord 2019; 246: 105-11.
[http://dx.doi.org/10.1016/j.jad.2018.12.012] [PMID: 30578944]
[29]
Yan D, Dai C, Xu R, Huang Q, Ren W. Predictive ability of systemic inflammation response index for the risk of pneumonia in patients with acute ischemic stroke. Gerontology 2023; 69(2): 181-8.
[http://dx.doi.org/10.1159/000524759] [PMID: 35584610]

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