scholarly journals KORELASI ANTARA RASIO NEUTROFIL LIMFOSIT DENGAN VOLUME INFARK SEREBRI PADA PENDERITA STROKE ISKEMIK AKUT

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Ilsa Hunaifi ◽  
Triana Dyah Cahyawati
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Infarct Volume ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Cross Sectional Design

 CORRELATION BETWEEN NEUTROFIL LIMPHOCYTE RATIO AND CEREBRAL INFARCTION VOLUME IN ACUTE ISCHAEMIC STROKEABSTRACTIntroduction: Inflammation plays a key role in stroke pathophysiology. Neutrophils is one of the earliest leucocyte subtypes to infiltrate the ischemia area of the brain. The neutrophil-lymphocyte ratio (NLR) is independent of the severity of coronary heart disease and as a predictor of poor clinical outcomes in patients with coronary heart disease undergoing angiography. The neutrophil-lymphocyte ratio values may be a prognostic factor in ischemic stroke patients. The neutrophil- lymphocyte ratio values can also be used in predicting infarct size, however limited study has been conducted in this area.Aim: To determine the correlation of NLR with cerebral infarct volume in acute ischemic stroke patients.Method: This was an analytical observational study with cross sectional design. The population for this study were acute ischemic stroke patients at NTB Genereal Hospital. The collected data were analyzed by Spearman correlation test.Results: Approximately 52 participants  were enrolled in this study with mean age was 59.79±8.65 years old. Hypertension was a common modifiable risk factor identified in more than 94.2 % participant. The mean of neutrophil lymphocyte ratio was 3.94±2.96 and mean of infarct volume was 13.96±37.26cm3. There was correlation between RNL and cerebral infract volume (r=+0.351; p=0.023).Discussions: Higher lymphocyte neutrophil ratio in acute ischemic stroke patients would result in an increase of brain infarct volume.Keyword: Infarct volume, ischaemic stroke, neutrophil lymphocyte ratioABSTRAKPendahuluan: Inflamasi memegang peranan penting dalam patofisiologi stroke. Salah satu subtipe dari sel leukosit yang paling awal menginfiltrasi ke area iskemia di otak adalah neutrofil. Rasio neutrofil limfosit (RNL) merupakan faktor independen terhadap beratnya penyakit jantung koroner dan sebagai prediktor luaran klinis yang buruk pada penderita penyakit jantung koroner yang menjalani angiografi. Nilai RNL dapat menjadi faktor prognostik pada penderita stroke iskemik. Nilai RNL juga bisa digunakan dalam memprediksi ukuran infark namun belum dilakukan penelitian hingga saat ini.Tujuan: Mengetahui korelasi RNL dengan volume infark serebri pada penderita stroke iskemik akut.Metode: Penelitian analitik observasional dengan desain potong lintang terhadap pasien stroke iskemik akut di RSUP NTB. Data yang terkumpul dianalisis dengan uji korelasi Spearman.Hasil: Didapatkan 52 subjek dengan rerata umur 59,79±8,65 tahun dan faktor risiko utama hipertensi (94,2%). Didapatkan rerata rasio neutrofil limfosit 3,94±2,96 dan rerata volume infark 13,96±37,26cm3. Terdapat korelasi antara RNL dengan volume infark serebri (r=+0,351; p=0,023).Diskusi: Semakin tinggi nilai rasio neutrofil limfosit mengakibatkan semakin luasnya volume infark serebri pada penderita stroke iskemik akut.Kata kunci: Rasio neutrofil limfosit, stroke iskemik, volume infark  

scholarly journals Correlation of neutrophil-to-lymphocyte ratio and clinical outcome of acute thrombotic stroke in patients with COVID-19

Narra J ◽  
2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Rizky Sarengat ◽  
Mohammad S. Islam ◽  
Mohammad S. Ardhi
Keyword(s):  
Ischemic Stroke ◽  
Clinical Outcome ◽  
Acute Ischemic Stroke ◽  
National Institutes Of Health ◽  
Neutrophil To Lymphocyte Ratio ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Lymphocyte Ratio ◽  
Life Threatening ◽  
The Mean

The coronavirus disease 2019 (COVID-19) pandemic has caused millions of deaths worldwide. Acute ischemic stroke is a life-threatening risk factor for COVID-19 infection. Neutrophil-to-lymphocyte ratio (NLR) is one of the predictors of poor prognosis in acute ischemic stroke. The aim of this study was to assess the correlation between NLR values and the clinical outcome of acute thrombotic stroke patients with COVID-19 that was measured using the National Institutes of Health Stroke Scale (NIHSS). A cross-sectional hospital-based study was conducted in Dr. Soetomo General Hospital Surabaya, Indonesia. Patients with acute thrombotic stroke and COVID-19 admitted between 1 March 2020 and 31 May 2021 were recruited. The NLR values and the NIHSS scores were assessed during the admission and the correlation between NLR and NIHSS scores was calculated. This study included 21 patients with acute thrombotic stroke and COVID-19, consisting of 12 males and 9 females. The mean age was 57.6 years old. The mean NLR values was 8.33±6.7 and the NIHSS scores ranging from 1 to 33. Our data suggested a positive correlation between NLR values and NIHSS scores, r=0.45 with p=0.041. In conclusion, the NLR value is potentially to be used as a predictor of the clinical outcome in acute thrombotic stroke patients with COVID-19. However, further study is warranted to validate this finding.

scholarly journals CORRELATION BETWEEN NEUTROPHIL-TO-LYMPHOCYTE RATIO AND HIGH SENSITIVITY C REACTIVE PROTEIN WITH SEVERITY AND OUTCOME IN ACUTE ISCHEMIC STROKE PATIENT

2020 ◽  
Vol 7 (8) ◽  
pp. 75-80
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
High Sensitivity ◽  
Neutrophil To Lymphocyte Ratio ◽  
C Reactive Protein ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Acute Ischemic Stroke Patient ◽  
Lymphocyte Ratio ◽  
Reactive Protein

Background: Inflammation plays a role in the pathophysiology of cerebral ischemic and also an initial response to brain injury. Inflammation involving Blood and Brain Barrier disturbance, leukocyte infiltration, endothelial cells activation, oxidant and inflammatory mediator buildups which can develop rapidly within hours and can cause secondary injury to brain tissues Objectives: To determine the correlation between Neutrophil-to-Lymphocyte Ratio (NLR) and High Sensitivity C Reactive Protein (hsCRP) with severity and outcome in acute ischemic stroke patients Methods: This study used a cross-sectional design approach. Sampling was done at H. Adam Malik General Hospital Medan and taken as many as 38 subjects. NLR and hsCRP were examined on the first day of admission. Severity was assessed by using the National Institutes of Health Stroke Scale and the outcome was assessed by using the Modified Ranking Scale on the first and fourteenth day of admission. The data analysis used the contingency coefficient correlation test and gamma test. Results: Demographic characteristics of the subjects are; the average age is 62 years old, the highest educational level is high school graduate, and the most occupation is unemployed. There is a positive, moderate, and significant correlation between NLR and severity of acute ischemic stroke (r=0.511; p=0.001). There is a positive, moderate, and significant correlation between NLR and the outcome of acute ischemic stroke (r=0.463; p=0.001). There is a positive, very strong, and significant correlation between hsCRP and severity of acute ischemic stroke (r=0.896; p=0.001). There is a positive, strong, and significant correlation between hsCRP and outcome of acute ischemic stroke (r=0.624; p=0.001) Conclusions: There is a positive and significant correlation between NLR and hsCRP with severity and outcome in acute ischemic stroke patients.

scholarly journals Incident Cancer in a Cohort of 3,247 Cancer Diagnosis Free Ischemic Stroke Patients

2015 ◽  
Vol 39 (5-6) ◽  
pp. 262-268 ◽  
Author(s):  
Adnan I. Qureshi ◽  
Ahmed A. Malik ◽  
Omar Saeed ◽  
Malik M. Adil ◽  
Gustavo J. Rodriguez ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
General Population ◽  
Annual Rate ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Incident Cancer ◽  
Race Ethnicity ◽  
Age Adjusted Rates

Background: Subclinical cancer can manifest as a thromboembolic event and may be detected at a later interval in ischemic stroke survivors. We determined the rate of incident cancer and effect on cardiovascular endpoints in a large cohort of ischemic stroke survivors. Methods: An analysis of 3,680 adults with nondisabling cerebral infarction who were followed for two years within the randomized, double-blinded VISP trial was performed. The primary intervention was best medical/surgical management plus a daily supplementation of vitamin B6, vitamin B12, and folic acid. We calculated age-adjusted rates of incidence of cancer among ischemic stroke survivors and standardized incidence ratios (SIR) with 95% confidence intervals (CI) based on comparison with age-adjusted rates in the general population. The significant variables from univariate analysis were entered in a Cox Proportional Hazards analysis to identify the association between various baseline factors and incident cancer after adjusting age, gender, and race/ethnicity. A logistic regression analysis evaluated the association between incident cancer and various endpoints including stroke, coronary heart disease, myocardial infarction, and death after adjusting age, gender, and race/ethnicity. Results: A total of 3,247 patients (mean age ± SD of 66 ± 11; 2,013 were men) were cancer free at the time of enrollment. The incidence of new cancer was 0.15, 0.80, 1.2, and 2.0 per 100 patients at 1 month, 6 months, 1 year, and 2 years, respectively. The age-adjusted annual rate of cancer in patients with ischemic stroke was higher than in persons in the general population at 1 year (581.8/100,000 persons vs. 486.5/100,000 persons, SIR 1.2, 95% CI 1.16-1.24) and 2 years (1,301.7/100,000 vs. 911.5/100,000, SIR 1.4, 95% CI 1.2-1.6) after recruitment. There was a higher risk for death (odds ratio (OR) 3.1, 95% CI 1.8-5.4), and composite endpoint of stroke, coronary heart disease, and/or death (OR 1.4, 95% CI 1.0-2.2) among participants who developed incident cancer compared with those who were cancer free after adjusting for potential confounders. Conclusions: The annual rate of age-adjusted cancer incidence was higher among ischemic stroke patients compared with those in the general population. The odds of mortality were three folds higher among stroke survivors who developed incident cancer.

scholarly journals HUBUNGAN ANTARA PERUBAHAN KADAR HS-CRP DENGAN FUNGSI KOGNITIF PADA STROKE ISKEMIK

2018 ◽  
Vol 35 (2) ◽  
Author(s):  
Betsi Sumanti ◽  
Hexanto Hexanto ◽  
Widiastuti Widiastuti
Keyword(s):  
Ischemic Stroke ◽  
Cognitive Function ◽  
Acute Ischemic Stroke ◽  
Inflammatory Marker ◽  
Cross Sectional Study ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Reactive Protein ◽  
Hs Crp ◽  
Relationship Of

   ASSOCIATION BETWEEN ALTERED HS-CRP LEVELS AND  COGNITIVE FUNCTION OF ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: The incidence of cognitive impairment in acute ischemic stroke patients is increasing. The mechanism of the inflammatory effect, such as  elevated hs-CRP level, a  non-specific inflammatory marker  sensitive to chronic inflammation due to hypoperfusion as well other vascular risk, is thought to have an effect on cognitive function.Aims: To determine the relationship of cognitive function changes in acute phase of ischemic stroke with hs-CRP level changes on day 3 and day 7 after onset.Methods: This was a cross sectional study of 31 first-timer ischemic stroke patients who met inclusion and exclusion criteria. The level of hs-CRP was checked on the 3rd day and 7th day after onset, while MoCA-Ina was assessed on the 7th day after onset. Cognitive disturbance was considered if MoCA <26. Analyses was done using SPSS 2.0Results: The average onset of day 3 Hs-CRP concentration was 0.66 (0.12-16.67)mg/dl and the onset of day 7 was 5.455 (0.14-17.34)mg/dl. The mean change of hs-CRP level between 3 day and 7 day after onset was -0,16 (-3.32-4.95). There was a significant correlation between elevated hs-CRP levels on day 3 and day 7 after onset with cognitive function of acute ischemic stroke patients.Discussion: There was a significant correlation between elevated hs-CRP levels on day 3 and day 7 after onset with cognitive function of acute ischemic stroke patients.Keyword: Acute ischemic stroke, hs-CRP, MoCA-Ina scoresABSTRAKPendahuluan: Insidens penurunan fungsi kognitif pada pasien stroke iskemik akut semakin meningkat. Hal ini diduga dipengaruhi oleh mekanisme efek inflamasi, meliputi peningkatan kadar high sensitive-C reactive protein (hs-CRP), salah satu penanda inflamasi non-spesifik yang sangat sensitif pada inflamasi kronis, akibat hipoperfusi maupun karena risiko vaskuler lainnya.Tujuan: Mengetahui hubungan perubahan fungsi kognitif pasien stroke iskemik fase akut dengan perubahan kadar hs-CRP hari ke-3 dan hari ke-7 setelah awitan.Metode: Studi potong lintang terhadap penderita stroke iskemik pertama kali yang memenuhi kriteria inklusi dan eksklusi. Dilakukan pemeriksaan kadar hs-CRP hari ke-3 dan hari ke-7 setelah awitan dan MoCA-Ina pada hari ke-7 setelah awitan. Fungsi kognitif dinyatakan terganggu jika MoCA-Ina <26. Analisis data menggunakan program SPSS 22.0.Hasil: Didapatkan rerata kadar Hs-CRP hari ke-3 setelah awitan adalah 0,66 (0,12-16,67)mg/dl dan hari ke-7 setelah awitan adalah 5,455 (0,14-17,34)mg/dl. Dengan rerata perubahan kadar hs-CRP awitan hari ke-3 dan awitan hari ke-7 adalah -0,16 (-3,32-4,95). Didapatkan hubungan yang bermakna antara perubahan kadar hs-CRP hari ke-3 setelah awitan dan hari ke-7 setelah awitan dengan fungsi kognitif pasien stroke iskemik akut.Kesimpulan: Didapatkan hubungan yang bermakna antara peningkatan kadar hs-CRP pada hari ke-7 dan kadar hari ke-3 dengan fungsi kognitif pasien stroke iskemik akut.Kata kunci: hs-CRP, MoCA-Ina, stroke iskemik akut 

scholarly journals KADAR FIBRIN MONOMER DAN UKURAN INFARK DI STROK ISKEMIK AKUT

2016 ◽  
Vol 20 (3) ◽  
pp. 171
Author(s):  
Ani Kartini ◽  
Mansyur Arif ◽  
Hardjoeno Hardjoeno
Keyword(s):  
Ischemic Stroke ◽  
Infarct Size ◽  
Acute Ischemic Stroke ◽  
Thrombus Formation ◽  
Infarct Volume ◽  
Cross Sectional Study ◽  
Cerebral Infarct ◽  
Cross Sectional ◽  
Fibrin Monomer ◽  
Significant Difference

Coagulation activation and thrombosis frequently exist in ischemic stroke, thrombus formation can be detected early by the presence of fibrin monomer. The purpose of this study was to know the correlation of fibrin monomer level with cerebral infarct size in acute ischemic stroke patients. This was a cross sectional study with a total of 39 samples. The fibrin monomer level was determined by immunoturbidimetry method using STA-Compact and the measurement of the infarct size was done by CT scan of the head using Broderick formula. The results of this study showed that the median level of fibrin monomer in acute ischemic stroke with nonlacunar infarct type and lacunar infarct type were 14.46 μg/mL and 4.29 μg/mL, respectively. Mann-Whitney test showed there was a significant difference of fibrin monomer levels between nonlacunar infarct type and the lacunar type, p=0.000. The cut-off point analysis result of the fibrin monomer level was 5.96 μg/mL with a sensitivity of 88.9% and specificity of 76.4%, respectively. Spearman correlation test showed that fibrin monomer level was positively correlated with cerebral infarct volume in acute ischemic stroke (r=0.56, p=0.000). Based on this study, it can be concluded that fibrin monomer level can be used as a marker to predict the type of cerebral infarct and volume of acute ischemic stroke as well.

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