# Inflammatory Biomarkers are Associated with Intimal Intracranial Artery Calcification

## TL;DR

This study found that higher RPR levels are linked to intimal artery calcification and worse stroke recovery outcomes.

## Contribution

The study identifies RPR as a novel inflammatory biomarker associated with intimal intracranial artery calcification and stroke outcomes.

## Key findings

- Higher RPR levels are associated with intimal versus medial calcification (OR = 1.53).
- Higher RPR levels are linked to worse functional outcomes after stroke (OR = 1.43).

## Abstract

Aim and Background: The aim of this study was to evaluate the association between inflammatory markers, Red Blood Cell to Platelet Ratio (RPR) and the Red Cell Distribution Width (RDW%) with intracranial artery calcification subtypes and the severity of ischemic stroke.

Methods: A total of 118 patients with a mean age of 67.3±12.5 years, of whom 49% were female, with ischemic stroke were prospectively enrolled. The study was conducted at a single center. Intracranial artery calcification was evaluated using a standardized methodology, differentiating mainly intimal from mainly medial, mixed type (medial and intimal calcification), and lack of arterial calcification. In addition, a new categorical variable representing stroke outcome was created based on the change in modified Rankin Scale (mRS) scores between admission and discharge. Inflammatory markers were assessed based on CBC results collected from each patient with ischemic stroke.

Results: Patients with a predominantly intimal type of intracranial artery calcification had significantly higher RPR levels compared to those with predominantly medial or mixed-type calcification. In a multinomial logistic regression analysis adjusted for age, sex, diabetes, dyslipidemia, hypertension, smoking status, NIHSS at admission, and mRS at discharge, each standard deviation (SD) increase in RPR was associated with a higher likelihood of having intimal versus medial calcification (OR = 1.53; 95% CI: 1.06-2.11; p = 0.022), and intimal versus mixed-type calcification (OR = 1.34; 95% CI: 1.03-1.75; p = 0.027). Moreover, higher RPR levels were independently associated with worse functional outcomes after stroke (OR = 1.43; 95% CI: 1.09-1.88; p = 0.009).

Conclusion: We found that higher RPR were significantly correlated with intracranial intimal artery calcification and worse functional outcomes in patients with ischemic stroke, as indicated by increased modified mRS scores at discharge.