国家神经系统疾病临床医学研究中心数据管理与共享系统

发表杂志：Angiology

发表类型: Original Article

影响因子(IF): 3.299

PMID: 37477872 Pubmed原文链接 全文下载

Intracranial atherosclerotic stenosis (ICAS) is a significant cause of ischemic stroke in the world.1 Inflammation plays an important role in cerebral vascular disease, including ICAS.2 Fibrinogen activates the inflammatory response while albumin demonstrates an anti-inflammatory and antithrombotic effect.3, 4 Fibrinogen to albumin ratio (FAR), as an inflammatory marker, is reported to be a significant predictor of acute coronary syndrome and is associated with the vascular atherosclerotic process.5 However, the association between FAR and ICAS has not been reported. Therefore, we aimed to use the large sample data to explore the association between FAR and ICAS in ischemic stroke patients based on The Third China National Stroke Registry (CNSR-III).

Population This study was based on CNRS-Ⅲ. Acute ischemic stroke patients with imaging data from CNRS-Ⅲ were included in our study. We excluded patients who were: 1) diagnosed with transient ischemic attack (TIA); 2) missed data of laboratory tests; 3) loss of imaging data. Data collection Baseline demographics and clinical information included age, sex, BMI, blood pressure, previous medical history of TIA, stroke, hypertension, coronary heart disease, dyslipidemia, diabetes, cigarette smoking, alcohol consumption, and antihypertensive therapy, statin therapy, antiplatelet therapy. BMI was calculated as weight (kg) divided by the square of height (m2). Functional status and stroke severity were evaluated at admission using the modified Rankin scale (mRS) score and the National Institutes of Health Stroke Scale (NIHSS). Stroke subtype were clarified according to the Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification.6 Blood samples were collected within 24 h of admission as the previous study reported.7 Laboratory tests including serum creatinine, fibrinogen, albumin, white blood cell count, cholesterol, triglycerides, LDL, HDL, serum homocysteine level were conducted by experienced researchers. The patients were categorized into quartile groups according to the FAR. Statistical analyses Patients’ characteristics were reported as percentages for categorical variables and median with interquartile range (IQR) or mean with standard deviation (SD) for continuous variables. Statistical comparisons between four different groups were performed with the Chi-square test or Fisher’s exact test, one-way analysis of variance or Kruskal-Wallis H-test, as appropriate. Univariable and multivariable analyses with logistic regression were used to determine the association between FAR groups and ICAS. Variables were adjusted including age, sex, NIHSS score at admission, premorbid mRS, TOAST classification, previous medical history of stroke, hypertension, coronary heart disease, dyslipidemia, diabetes, cigarette smoking, alcohol consumption, and statin therapy, antiplatelet therapy, antihypertensive therapy. In the subgroup analysis, we divided ICAS into symptomatic and asymptomatic ICAS. Univariable and multivariable analyses with logistic regression were used to determine the association between FAR groups and the two ICAS subgroups. All tests were two-tailed, and P < 0.05 was considered statistically significant. All analyses were conducted using R software version 4.0.2 and SAS version 9.4 statistical software (SAS Institute Inc., Cary, North Carolina, USA).