Issue: Vojnosanit Pregl 2016; Vol. 73 (No. 6)
Leucocyte count indicates carotid plaque instability in stroke patients
Authors:
Gordana Arandjelović Minić
Background/Aim. Increasing evidence points to the inflammatorycharacter of atherosclerosis and several parameters
of inflammation have been proposed as cerebrovascular
risk markers. The objective of the research was to examine
the connection of serum inflammatory parameters and ultrasound
(US) characteristics of the structure and size of carotid
plaque. We assumed that the number of leukocytes
(Le) was an indicator of carotid plaque instability and an increased
risk of stroke. Methods. Serum inflammatory parameters:
erythrocyte sedimentation rate in the first (ESR I)
and second hour (ESR II), the number of Le, high sensitivity
C-reactive protein (hsCRP) and fibrinogen were measured
by standard methods. All the subjects (n = 75) were
divided into 3 groups (symptomatic, asymptomatic and control).
US evaluation of extracranial carotid arteries was performed
in a duplex system. Plaques were classified into categories
according to stenosis percentage (≥ 50%, < 50%)
and pursuant to echomorphological characteristics (Gray-
Weale classification). In the subjects with stroke an ischemic
lesion was confirmed by computed tomography. Results.
The average values of biochemical parameters in the symptomatic
group were: ESR I 29.57 ± 29.87 cm, ESR II 51.60
± 36.87 cm, the number of Le 10.10 ± 3.20 10-9 U/L, hs-
CRP 8.15 ± 5.50 mg/L and fibrinogen 4.03 ± 0.70 g/L.
The average values of all testing biochemical parameters in
symptomatic patients were significantly higher than in the
asymptomatic ones and the control group: for ESR I (p <
0.05) and ESR II (p < 0.05); for the number of Le (p <
0.001); for hsCRP (p < 0.001) and fibrinogen (p < 0.001).
Category I of echomorphological characteristics in the
symptomatic group was present in 66.7% of the cases and it
was significantly higher than in the asymptomatic (40.0%; p
< 0.05) and the control group (20.0%; p < 0.01). Univariate
logistic regression analysis confirmed that all testing biochemical
parameters are indicators of stroke risk. Multivariate
logistic regression analysis confirmed a statistically significant
correlation of the number of Le and stroke risk,
while the increase in the value by a unit of measurement
was associated with the growth of risk by 3.22 times (from
1.67 to 6.22). Conclusion. The number of Le is associated
with the phenomenon of carotid plaque instability and may
be a useful additional marker of increased risk for developing
acute cerebral infarction.
