Clinical value of neutrophil-to-apolipoprotein A1 ratio(NAR)combined with homocysteine in predicting cerebral infarction after transient ischemic attack
SONG Ye
SUN Aqiao
WEI Linlin
WANG Xia
LI Minling
Abstract：Objective To explore the clinical value of neutrophil-to-apolipoprotein A1 ratio(NAR)combined with homocysteine(Hcy)in predicting cerebral infarction after transient ischemic attack(TIA).Methods A total of 202 patients with newly diagnosed TIA admitted to the First Affiliated Hospital of Xi'an Jiaotong University from February 2021 to December 2023 were enrolled and divided into cerebral infarction progression group(36 cases)and non-cerebral infarction group(166 cases)based on whether they progressed to cerebral infarction within 3 months after TIA.The NAR and Hcy levels of the two groups at admission were compared.The predictive value of NAR,Hcy,and their combination for the progression of TIA on cerebral infarction was analyzed using the ROC curve.The influencing factors of TIA progression on cerebral infarction were explored by multivariate Logistic stepwise regression analysis.Results The NAR and Hcy levels in the cerebral infarction progression group were higher than those in the non-cerebral infarction group(P<0.05).The AUC(95%CI)of NAR,Hcy,and their combination for predicting the progression of TIA on cerebral infarction were 0.839(0.794-0.889),0.714(0.664-0.764),and 0.927(0.877-0.972)respectively.The combination of the two had the best predictive performance(P<0.05).The levels of FBG and the proportions of patients with hypertension,diabetes,and TIA duration≥30 minutes in the cerebral infarction progression group were higher than those in the non-cerebral infarction group(P<0.05).Multivariate analysis showed that hypertension(OR=2.494,95%CI:1.196-5.202),diabetes(OR=2.092,95%CI:1.160-3.773),TIA duration(OR=2.344,95%CI:1.228-4.476),NAR(OR=3.808,95%CI:1.936-7.487),and serum Hcy(OR=3.333,95%CI:1.770-6.278)were risk factors for the progression of TIA on cerebral infarction(P<0.05).Conclusions The combined detection of NAR and Hcy can effectively predict the risk of cerebral infarction after TIA,and its clinical value lies in quantifying inflammation,lipid metabolism imbalance,and vascular damage,helping to screen high-risk patients who require enhanced intervention,and providing objective basis for early initiation of antithrombotic therapy or targeted Hcy lowering therapy,thereby reducing the risk of disabling stroke.
Keywords：transient ischemic attackcerebral infarctionneutrophil-to-apolipoprotein A1 ratiohomocysteineclinical valueinfluencing factors
Publication Date：2025-10-28
Online Publishing Date：2025-10-09(First online date of this platform, not the publication date of the document)
Pages：5( 76-80 )