Xiaotong Ma,1,2 Wenjuan Wang,2 Yumeng Yang,1 Jiao Li,2 Chenhuai Wang,2 Qinjian Sun,2 Zhangyong Xia3– 6 

1Department of Neurology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, 250012, People’s Republic of China; 2Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, 250012, People’s Republic of China; 3Department of Neurology, Liaocheng People’s Hospital, Shandong University, Jinan, Shandong, 250012, People’s Republic of China; 4Department of Neurology, the Second People’s Hospital of Liaocheng, Liaocheng, Shandong, 252000, People’s Republic of China; 5Department of Neurology, Liaocheng People’s Hospital, Liaocheng, Shandong, 252000, People’s Republic of China; 6State Key Laboratory of Dampness Syndrome of Chinese Medicine, Shandong Sub-Centre, Liaocheng, Shandong, 252000, People’s Republic of China

Correspondence: Zhangyong Xia, Department of Neurology, Liaocheng People’s Hospital, Shandong University, Jinan, Shandong, 250012, People’s Republic of China, Email xiazhangyong2013@163.com Qinjian Sun, Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, No. 324 Jingwu Weiqi Road, Jinan, Shandong, 250021, People’s Republic of China, Email sqj1210@163.com

Background: Plaque enhancement is a non-specific marker of local inflammatory response, which may offer additional insights together with circulating inflammatory markers. Few studies have analyzed the association between intracranial atherosclerotic stenosis (ICAS) plaque enhancement and circulating inflammatory markers. Given the age-related variability in the progression of ICAS, this study aims to explore the association between the two across different age groups.
Methods: This retrospective study recruited 120 patients with ICAS-related ischemic events who had undergone high-resolution magnetic resonance imaging. Plaque enhancement index at the most stenosed site of the culprit vessel was calculated. Levels of circulating inflammatory indicators, including high-sensitivity C-reactive protein (hsCRP), lymphocyte-to-white blood cell ratio (LWR), systemic immune inflammation index (SII), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and neutrophil-to-lymphocyte ratio (NLR), were detected. General linear regression models were established to analyze the association between ICAS plaque enhancement index and circulating inflammatory indicators.
Results: In this study, hsCRP, but not other circulating inflammatory indicators, had a significant positive association with ICAS plaque enhancement index (β=0.219, 95% CI [0.036, 0.349], P=0.02). After multivariate adjustment, there was still a marginal correlation between hsCRP and the enhancement index (β=0.220, 95% CI [0.025, 0.362], P=0.05). The association was particularly significant in patients < 60 years rather than those ≥ 60 years. For participants < 60 years, hsCRP had the highest contribution to plaque enhancement interpretation.
Conclusion: ICAS plaque enhancement index was positively associated with hsCRP, particularly in participants aged < 60 years. This may be helpful for understanding the significance of the enhancement index in clinical practice.

Keywords: circulating inflammatory indicators, high-sensitivity C-reactive protein, plaque enhancement index, intracranial atherosclerosis