Systemic immune-inflammation index predicts first stroke and affects the efficacy of folic acid in stroke prevention
Background: Systemic immune-inflammation index (SII) is a novel biomarker of growing interest in predicting stroke. The aim of this study was to investigate its predictive value and explore its effect modification on folic acid supplement for stroke primary prevention in a Chinese population with hy...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-02-01
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| Series: | Heliyon |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844024008685 |
| _version_ | 1797304585265610752 |
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| author | Xiying Chi Nan Zhang Fangfang Fan Jia Jia Jianhang Zheng Lishun Liu Yun Song Binyan Wang Genfu Tang Xianhui Qin Yong Huo Jianping Li |
| author_facet | Xiying Chi Nan Zhang Fangfang Fan Jia Jia Jianhang Zheng Lishun Liu Yun Song Binyan Wang Genfu Tang Xianhui Qin Yong Huo Jianping Li |
| author_sort | Xiying Chi |
| collection | DOAJ |
| description | Background: Systemic immune-inflammation index (SII) is a novel biomarker of growing interest in predicting stroke. The aim of this study was to investigate its predictive value and explore its effect modification on folic acid supplement for stroke primary prevention in a Chinese population with hypertension. Methods: A total of 10,013 participants from the China Stroke Primary Prevention Trial with available neutrophil, platelet and lymphocyte count were included, including 5,019 subjects in the enalapril group and 4,994 in the enalapril-folic acid group. SII was calculated as (platelet × neutrophil)/lymphocyte. The primary endpoint was first stroke. Cox proportional hazards models were used to evaluate the association between SII and first stroke. Results: A U-shape association between SII and first stroke risk was observed in enalapril group. Compared with the reference group (Quartile 2: 335.1 to <443.9 × 109 cell/L), the adjusted HRs were 1.68 (95 % CI: 1.06–2.66, P = 0.027) in Quartile 1 (<335.1 × 109 cell/L), 1.43 (95 % CI: 0.90–2.27, P = 0.126) in Quartile 3 (443.9 to <602.6 × 109 cell/L), and 1.61 (95 % CI: 1.03–2.51, P = 0.035) in Quartile 4 (≥602.6 × 109 cell/L). There was no significant association between SII and first stroke in the enalapril-folic acid group, with adjusted HR of 0.92 (95%CI: 0.54–1.56, P = 0.749) in Quartile 1(<334.7 × 109 cell/L), 1.36 (95%CI: 0.84–2.21, P = 0.208) in Quartile 3 (446.2 to <595.2 × 109 cell/L), and 1.41 (95%CI: 0.87–2.27, P = 0.163) in Quartile 4 (≥595.2 × 109 cell/L). A remarkable interaction between baseline SII and folic acid supplement for stroke prevention was observed, with particularly reduced risk by 44 % (HR: 0.56; 95 % CI: 0.34–0.90; P = 0.018) in the lowest SII group (P for interaction = 0.041). Conclusions: Among Chinese adults with hypertension, both low and high SII at baseline predicted increased first stroke risk. And compensatory folic acid particularly reduced first stroke risk in the lowest SII subgroup. |
| first_indexed | 2024-03-08T00:12:31Z |
| format | Article |
| id | doaj.art-d683d707a6754eef86a93942d572841c |
| institution | Directory Open Access Journal |
| issn | 2405-8440 |
| language | English |
| last_indexed | 2024-03-08T00:12:31Z |
| publishDate | 2024-02-01 |
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| spelling | doaj.art-d683d707a6754eef86a93942d572841c2024-02-17T06:38:49ZengElsevierHeliyon2405-84402024-02-01103e24837Systemic immune-inflammation index predicts first stroke and affects the efficacy of folic acid in stroke preventionXiying Chi0Nan Zhang1Fangfang Fan2Jia Jia3Jianhang Zheng4Lishun Liu5Yun Song6Binyan Wang7Genfu Tang8Xianhui Qin9Yong Huo10Jianping Li11Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China; Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, ChinaDepartment of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China; Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, ChinaDepartment of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China; Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, ChinaDepartment of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China; Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, ChinaResearch Center of Biostatistics and Computational Pharmacy, China Pharmaceutical University, Nanjing 211198, ChinaGraduate School at Shenzhen, Tsinghua University, Shenzhen, China; Shenzhen Evergreen Medical Institute, Shenzhen, ChinaShenzhen Evergreen Medical Institute, Shenzhen, China; Institute for Biomedicine, Anhui Medical University, Hefei, China; AUSA Research Institute, Shenzhen AUSA Pharmed Co Ltd, Shenzhen, ChinaInstitute for Biomedicine, Anhui Medical University, Hefei, ChinaSchool of Health Administration, Anhui Medical University, Hefei, 230000, ChinaNational Clinical Research Study Center for Kidney Disease, The State Key Laboratory for Organ Failure Research, Renal Division, Nanfang Hospital, Southern Medical University, Guangzhou, ChinaDepartment of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China; Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, ChinaDepartment of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China; Institute of Cardiovascular Disease, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China; Corresponding author. Department of Cardiology, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.Background: Systemic immune-inflammation index (SII) is a novel biomarker of growing interest in predicting stroke. The aim of this study was to investigate its predictive value and explore its effect modification on folic acid supplement for stroke primary prevention in a Chinese population with hypertension. Methods: A total of 10,013 participants from the China Stroke Primary Prevention Trial with available neutrophil, platelet and lymphocyte count were included, including 5,019 subjects in the enalapril group and 4,994 in the enalapril-folic acid group. SII was calculated as (platelet × neutrophil)/lymphocyte. The primary endpoint was first stroke. Cox proportional hazards models were used to evaluate the association between SII and first stroke. Results: A U-shape association between SII and first stroke risk was observed in enalapril group. Compared with the reference group (Quartile 2: 335.1 to <443.9 × 109 cell/L), the adjusted HRs were 1.68 (95 % CI: 1.06–2.66, P = 0.027) in Quartile 1 (<335.1 × 109 cell/L), 1.43 (95 % CI: 0.90–2.27, P = 0.126) in Quartile 3 (443.9 to <602.6 × 109 cell/L), and 1.61 (95 % CI: 1.03–2.51, P = 0.035) in Quartile 4 (≥602.6 × 109 cell/L). There was no significant association between SII and first stroke in the enalapril-folic acid group, with adjusted HR of 0.92 (95%CI: 0.54–1.56, P = 0.749) in Quartile 1(<334.7 × 109 cell/L), 1.36 (95%CI: 0.84–2.21, P = 0.208) in Quartile 3 (446.2 to <595.2 × 109 cell/L), and 1.41 (95%CI: 0.87–2.27, P = 0.163) in Quartile 4 (≥595.2 × 109 cell/L). A remarkable interaction between baseline SII and folic acid supplement for stroke prevention was observed, with particularly reduced risk by 44 % (HR: 0.56; 95 % CI: 0.34–0.90; P = 0.018) in the lowest SII group (P for interaction = 0.041). Conclusions: Among Chinese adults with hypertension, both low and high SII at baseline predicted increased first stroke risk. And compensatory folic acid particularly reduced first stroke risk in the lowest SII subgroup.http://www.sciencedirect.com/science/article/pii/S2405844024008685Systemic immune-inflammation indexFirst strokeHypertensionCSPPT |
| spellingShingle | Xiying Chi Nan Zhang Fangfang Fan Jia Jia Jianhang Zheng Lishun Liu Yun Song Binyan Wang Genfu Tang Xianhui Qin Yong Huo Jianping Li Systemic immune-inflammation index predicts first stroke and affects the efficacy of folic acid in stroke prevention Heliyon Systemic immune-inflammation index First stroke Hypertension CSPPT |
| title | Systemic immune-inflammation index predicts first stroke and affects the efficacy of folic acid in stroke prevention |
| title_full | Systemic immune-inflammation index predicts first stroke and affects the efficacy of folic acid in stroke prevention |
| title_fullStr | Systemic immune-inflammation index predicts first stroke and affects the efficacy of folic acid in stroke prevention |
| title_full_unstemmed | Systemic immune-inflammation index predicts first stroke and affects the efficacy of folic acid in stroke prevention |
| title_short | Systemic immune-inflammation index predicts first stroke and affects the efficacy of folic acid in stroke prevention |
| title_sort | systemic immune inflammation index predicts first stroke and affects the efficacy of folic acid in stroke prevention |
| topic | Systemic immune-inflammation index First stroke Hypertension CSPPT |
| url | http://www.sciencedirect.com/science/article/pii/S2405844024008685 |
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