Clinical efficacy of atorvastatin calcium combined with aspirin in patients with acute ischemic stroke and effect on neutrophils, lymphocytes and IL-33

IL-33 in Ischemic Stroke: Brain vs. Periphery

Cerebrovascular disease is the second-leading cause of death and disability worldwide, with stroke being the most common cause. In ischemic stroke, several processes combine to produce immunosuppression, leaving the post-stroke body susceptible to infection, which in turn affects neuroinflammation. Interleukin-33 (IL-33), a member of the interleukin-1 family (IL-1), functions as a modulator of immune responses and inflammation, playing a crucial role in the establishment of immunologic responses. IL-33 has been shown to have a protective effect on brain injury and represents a potential target by modulating inflammatory cytokines and stimulating immune regulatory cells. With an emphasis on preclinical and clinical studies, this review covers the impact of IL-33 on immune system mechanisms following ischemic stroke.

Comparison of efficacy and safety between loading-dose atorvastatin and rosuvastatin in cerebral infarction

OBJECTIVE

To analyze the efficacy and safety of loading-dose atorvastatin and rosuvastatin in the treatment of cerebral infarction (CI).

METHODS

A total of 151 CI patients treated at the Third Affiliated Hospital of Qiqihar Medical University from January 2015 to February 2020 retrospectively were selected and divided into four groups: conventional atorvastatin, loading-dose atorvastatin, conventional rosuvastatin, and loading-dose rosuvastatin. Primary outcomes assessed included changes in National Institutes of Health Stroke Scale (NIHSS) scores, clinical efficacy, alterations in serum lipid indices, liver function, inflammation markers, CI indices, and the incidence of adverse reactions.

RESULTS

After treatment, all groups showed a significant decrease in NIHSS scores (all P<0.0001). The loading-dose groups exhibited greater reductions in NIHSS scores compared to the conventional groups (both P<0.0001). No significant difference was found in NIHSS scores between the two loading-dose groups (P>0.05). The loading-dose groups demonstrated higher efficacy than the conventional groups (both P<0.05), with no significant difference between the two loading-dose groups (both P>0.05). Loading-dose rosuvastatin showed superior improvement in blood lipid control compared to loading-dose atorvastatin (P<0.05). There were no significant differences in liver function indices among the groups (all P>0.05). Inflammation and myocardial indices intensified 24 hours after treatment, with milder intensification in the loading-dose rosuvastatin group compared to the loading-dose atorvastatin group (P<0.05). The incidences of adverse reactions did not significantly differ among the groups (all P>0.05).

CONCLUSION

Both loading-dose atorvastatin and rosuvastatin demonstrated increased clinical efficacy in the treatment of CI patients, ensuring safety and effectiveness. However, rosuvastatin exhibited superior efficacy in blood lipid control. These findings provide valuable guidance for the clinical management of CI.

Dynamic change of neutrophil-to-lymphocyte ratio and its predictive value of prognosis in acute ischemic stroke

OBJECTIVE

The present research aimed to explore the dynamic change of the neutrophil-to-lymphocyte ratio (NLR) and its relationship with functional outcome following an acute ischemic stroke (AIS), whether receiving intravenous thrombolysis (IVT) or not.

METHODS

We retrospectively analyzed data that were prospectively acquired from patients with AIS treated with IVT or not. For patients receiving IVT, the NLR was based on a blood test performed prior to IVT (d0) and at different time points after disease onset (d1, d3, d7). In addition, in the non-IVT group, the NLR was obtained at different time points after disease onset (d1, d3, d7). Follow-ups were performed 3 months after onset via telephone. In addition, a good outcome was defined as a modified Rankin scale (mRS) ≤1; a poor outcome means 2 ≤ mRS ≤ 6.

RESULTS

A total of 204 AIS patients were included in this study. The NLR presented a dynamic change as it increased to its peak at day 1 and gradually declined to its baseline at day 7, no matter whether patients were receiving IVT or not. Patients with poor outcomes have a higher NLR at various time points. The results of multivariate logistic regression analysis demonstrated that the National Institutes of Health Stroke Scale (NIHSS), NLR d1, NLR d3, and NLR d7 were independently associated with functional outcomes. The area under the receiver operating characteristic curve of NLR in predicting outcomes was as follows: NLR d3 demonstrated robust predictive power within the IVT therapy cohort, whereas NLR d7 was predictive in the non-IVT cohort. However, the most potent predictor emerged as the combination of NIHSS and NLR.

CONCLUSION

NLR has the potential to predicate diagnosis for AIS, especially when combined with the NIHSS score.