J-shaped association of neutrophil-to-lymphocyte ratio with all-cause mortality and linear association with cardiovascular mortality in stroke survivors
BackgroundThe correlation between systemic inflammation and stroke has been well-established. Notably, the neutrophil-to-lymphocyte ratio (NLR) has been linked to poor outcomes and increased short-term mortality in acute ischemic stroke (AIS). This study aims to explore the association between NLR a...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2025.1473802/full |
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| author | Yiqiao Chen Tian Lv Wanyi Lin Tianjiao Meng Yi Sui Shiqin Chen |
| author_facet | Yiqiao Chen Tian Lv Wanyi Lin Tianjiao Meng Yi Sui Shiqin Chen |
| author_sort | Yiqiao Chen |
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| description | BackgroundThe correlation between systemic inflammation and stroke has been well-established. Notably, the neutrophil-to-lymphocyte ratio (NLR) has been linked to poor outcomes and increased short-term mortality in acute ischemic stroke (AIS). This study aims to explore the association between NLR and long-term mortality among stroke survivors.MethodsThis study analyzed data from 1,229 stroke survivors enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018. The participants were categorized according to quartiles of NLR level. Multivariate Cox regression and restricted cubic splines (RCS) were applied to evaluate the relationship between NLR and all-cause and cardiovascular disease (CVD) mortality.ResultsOver a median follow-up of 6.41 years, 485 deaths were recorded. After multivariate adjustment, individuals in the highest NLR quartile (Q4) demonstrated significantly higher risks of all-cause mortality (hazard ratio [HR] = 1.58, 95% confidence interval [CI]: 1.06–2.34) and CVD mortality (HR = 1.90, 95% CI: 1.07–3.37) compared to those in the lowest quartile (Q1). RCS analysis revealed a J-shaped relationship between NLR and all-cause mortality and a linear relationship with CVD mortality.ConclusionThese findings suggest a J-shaped association between NLR and all-cause mortality, along with a linear relationship between NLR and CVD mortality in stroke survivors. |
| format | Article |
| id | doaj-art-dd401617f73149cda81a4d81a42ec0f6 |
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| issn | 1664-2295 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Neurology |
| spelling | doaj-art-dd401617f73149cda81a4d81a42ec0f62025-08-20T02:18:00ZengFrontiers Media S.A.Frontiers in Neurology1664-22952025-03-011610.3389/fneur.2025.14738021473802J-shaped association of neutrophil-to-lymphocyte ratio with all-cause mortality and linear association with cardiovascular mortality in stroke survivorsYiqiao Chen0Tian Lv1Wanyi Lin2Tianjiao Meng3Yi Sui4Shiqin Chen5Department of Neurology, Qingtian People’s Hospital, Zhejiang, ChinaDepartment of Neurology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, ChinaDepartment of Neurology, Qingtian People’s Hospital, Zhejiang, ChinaDepartment of Neurology, Zhuji Affiliated Hospital of Wenzhou Medical University, Zhuji, ChinaThe Fourth People’s Hospital of Shenyang, China Medical University, Shenyang, ChinaDepartment of Neurology, Yuhuan Second People's Hospital, Yuhuan, ChinaBackgroundThe correlation between systemic inflammation and stroke has been well-established. Notably, the neutrophil-to-lymphocyte ratio (NLR) has been linked to poor outcomes and increased short-term mortality in acute ischemic stroke (AIS). This study aims to explore the association between NLR and long-term mortality among stroke survivors.MethodsThis study analyzed data from 1,229 stroke survivors enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2018. The participants were categorized according to quartiles of NLR level. Multivariate Cox regression and restricted cubic splines (RCS) were applied to evaluate the relationship between NLR and all-cause and cardiovascular disease (CVD) mortality.ResultsOver a median follow-up of 6.41 years, 485 deaths were recorded. After multivariate adjustment, individuals in the highest NLR quartile (Q4) demonstrated significantly higher risks of all-cause mortality (hazard ratio [HR] = 1.58, 95% confidence interval [CI]: 1.06–2.34) and CVD mortality (HR = 1.90, 95% CI: 1.07–3.37) compared to those in the lowest quartile (Q1). RCS analysis revealed a J-shaped relationship between NLR and all-cause mortality and a linear relationship with CVD mortality.ConclusionThese findings suggest a J-shaped association between NLR and all-cause mortality, along with a linear relationship between NLR and CVD mortality in stroke survivors.https://www.frontiersin.org/articles/10.3389/fneur.2025.1473802/fullJ-shapedstroke survivorsall-cause mortalitycardiovascular mortalityneutrophil-to-lymphocyte ratio |
| spellingShingle | Yiqiao Chen Tian Lv Wanyi Lin Tianjiao Meng Yi Sui Shiqin Chen J-shaped association of neutrophil-to-lymphocyte ratio with all-cause mortality and linear association with cardiovascular mortality in stroke survivors Frontiers in Neurology J-shaped stroke survivors all-cause mortality cardiovascular mortality neutrophil-to-lymphocyte ratio |
| title | J-shaped association of neutrophil-to-lymphocyte ratio with all-cause mortality and linear association with cardiovascular mortality in stroke survivors |
| title_full | J-shaped association of neutrophil-to-lymphocyte ratio with all-cause mortality and linear association with cardiovascular mortality in stroke survivors |
| title_fullStr | J-shaped association of neutrophil-to-lymphocyte ratio with all-cause mortality and linear association with cardiovascular mortality in stroke survivors |
| title_full_unstemmed | J-shaped association of neutrophil-to-lymphocyte ratio with all-cause mortality and linear association with cardiovascular mortality in stroke survivors |
| title_short | J-shaped association of neutrophil-to-lymphocyte ratio with all-cause mortality and linear association with cardiovascular mortality in stroke survivors |
| title_sort | j shaped association of neutrophil to lymphocyte ratio with all cause mortality and linear association with cardiovascular mortality in stroke survivors |
| topic | J-shaped stroke survivors all-cause mortality cardiovascular mortality neutrophil-to-lymphocyte ratio |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2025.1473802/full |
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