Association of peripheral blood inflammatory biomarkers and poor clinical outcomes in adult stroke patients with moyamoya disease.

PURPOSE: Stroke is the common manifestation of moyamoya disease (MMD). The study aimed to explore the correlation between inflammatory biomarkers and the poor clinical outcomes in adult stroke patients with MMD.

PATIENTS AND METHODS: The retrospective study included adult patients with MMD who were admitted to the First Affiliated Hospital of Guangxi Medical University from June 2012 to November 2023. Functional outcomes were assessed using the modified Rankin Scale (mRS) score. We assessed the area under the curves (AUC) for platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII) and neutrophil-to-albumin ratio (NAR) in predicting the poor clinical outcomes.

RESULTS: Overall 201 eligible MMD patients including 29 subjects without stroke, 97 subjects with ischemic stroke and 75 subjects with hemorrhagic stroke were collected. In MMD patients with ischemic stroke, those with poor outcomes had significantly higher levels of SII and NAR. The AUCs of SII and NAR were respectively 0.667 and 0.684, while the AUC for joint application was 0.683. In MMD patients with hemorrhagic stroke, those with poor outcomes had significantly higher levels of PLR, NLR, MLR, SII, and NAR. And the AUCs were respectively 0.678, 0.727, 0.643, 0.751, 0.744, while the AUC for joint application of these inflammatory biomarkers was 0.793, higher than a single indicator.

CONCLUSION: Higher SII and NAR levels were associated with poor clinical outcomes in MMD patients with ischemic stroke. Higher PLR, NLR, MLR, SII, and NAR levels were associated with poor clinical outcomes in MMD patients with hemorrhagic stroke.