High inflammation level is essential to cerebral microbleed in the prediction of large artery atherosclerotic outcomes

Abstract Background and Purpose: Cerebral small vessel damages and large artery atherosclerotic (LAA) stroke share many risk factors, such as inflammation, but little attention has been paid to the relationship between cerebral small vessel damages with inflammation in predicting large artery atherosclerotic stroke outcomes. Methods: We consecutively enrolled participants with LAA stroke and collected their baseline and follow-up data, especially the imaging markers of cerebral small vessel disease and C reactive protein (CRP), and neutrophil-to-lymphocyte ratio (NLR) levels. The primary outcomes were LAA stroke outcomes at 3-month and 1-year, the secondary outcomes poststroke hemorrhagic transformation, infarction recurrence, and mortality. Results: 864 participants were included to the final analysis. We found that only cerebral microbleed (CMB) with numbers greater than 5 can predict 3-month ( p < 0.001) and 1-year ( p < 0.01) outcomes in LAA stroke, furthermore when CMB is more than 5 plus NLR or CRP more than 3, the prediction in primary outcomes is significant (all p < 0.05), but not in secondary outcomes. Conclusions: Our multi-centered cohort study suggests that CMB counts > 5 were not associated with the prognosis of LAA stroke, and CMB counts > 5 with high levels of inflammation (NLR or CRP > 3) were associated with a poor prognosis of LAA stroke.