An Association between the Inflammatory Marker and Short-term Risk of Stroke in Patients with Transient Ischemic Attack and Low ABCD2 Score

Kim,  Myung Joong; Lee,  Chang Min; Park,  Sung Hyuk; Jung,  Woong; Park,  Hyun Kyung; Kim,  Myung Chun; Ko,  Young Gwan

J Korean Soc Emerg Med > Volume 25(1); 2014 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2014;25(1): 15-22.

An Association between the Inflammatory Marker and Short-term Risk of Stroke in Patients with Transient Ischemic Attack and Low ABCD2 Score

Myung Joong Kim, Chang Min Lee, Sung Hyuk Park, Woong Jung, Hyun Kyung Park, Myung Chun Kim, Young Gwan Ko

Department of Emergency Medicine, Kyung Hee University Hospital at Kangdong, College of Medicine, Kyung Hee University, Seoul, Korea. hyuk2127@naver.com

ABSTRACT

PURPOSE:
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction resulting from focal cerebral ischemia not associated with permanent cerebral ischemia and short-term risk of stroke after TIA is high. Inflammatory markers play an important role in acute brain ischemia. The purpose of this study was to investigate the association between the inflammatory markers and short-term risk of stroke in patients with TIA and low ABCD2 score.
METHODS:
The authors conducted a retrospective study of patients diagnosed with TIA in the emergency department (ED) from June 2006 to April 2013. A total of 282 patients diagnosed as TIA with low ABCD2 score were enrolled. Patients were divided into two groups according to occurrence of stroke within 90 days. We analyzed demographic characteristics, laboratory data, and comorbidities of each group.
RESULTS:
The median age of patients was 50.0(45.8-58.0) years, with 44.3% males. Based on the occurrence of stroke within 90 days, the patients were divided into 42 patients with stroke and 240 patients with non-stroke. Patients with stroke showed a high median age (p=0.027), white blood cell count (p=0.031), neutrophil to lymphocyte ratio (NLR) (p=0.033), C-reactive protein (p=0.005), and glucose (p=0.010). Results of multivariate analysis showed that NLR was a significant predictor of short-term prognosis (odds ratio 2.785, 95% confidence interval 1.453-5,340).
CONCLUSION:
NLR in the ED may be used as a rapid and easy to measure inflammatory marker for prediction of short-term prognosis in patients with transient ischemic attack and low ABCD2 score.

Key words: Transient ischemic attack, Risk assessment, Biological markers