FEATURES OF CHANGES IN COMPOSITE HEMOCYTOMETRIC INDICES OF BLOOD IN TRANSIENT ISCHEMIC ATTACK AND ISCHEMIC STROKE

Abstract

Introduction. It is known that transient ischemic attacks (TIAs) and established strokes do not differ in etiology and pathogenesis. The key distinction lies in the duration and reversibility of neurological symptoms. A diagnosis of TIA is made when neurological symptoms resolve within 24 hours. However, prompt differentiation between ischemic stroke (IS) and TIA is essential, as it enables timely initiation of appropriate treatment in IS patients. Ischemic brain injury triggers an inflammatory response that involves activation of resident brain cells and active participation of leukocytes. Platelets also play a crucial role in these processes, not only through their hemostatic function but also by closely interacting with leukocytes and modulating inflammatory and immune responses. A complete blood count (CBC) is a rapid and accessible method for evaluating immune status based on quantitative alterations in leukocyte subsets in peripheral blood. In recent years, composite hemocytometric indices (CHIs), which reflect the ratios of various leukocyte types as well as platelet-leukocyte interactions, have been used to assess systemic inflammatory responses. Objective: to identify characteristic changes in leukocyte parameters and composite hemocytometric indices in patients with transient ischemic attack and ischemic stroke. Materials and Methods. The study included 26 patients with TIA (mean age 49 ± 5.8 years) and 58 patients with ischemic stroke (mean age 54.5 ± 6.7 years). The control group consisted of 28 apparently healthy individuals without severe somatic diseases or a history of cerebrovascular disorders (mean age 49.3 ± 6.6 years). CBC parameters were assessed on the first day of illness. Absolute counts of leukocytes, neutrophils, lymphocytes, monocytes, and platelets were measured. CHIs were calculated, including the neutrophil-tolymphocyte ratio (NLR), systemic inflammatory response index (SIRI), neutrophil-to-platelet ratio (NPR), plateletto- lymphocyte ratio (PLR), and platelet-to-monocyte ratio (PMR). Results and Discussions. Patients with IS had significantly higher leukocyte and neutrophil counts compared to those with TIA and healthy individuals. An increase in neutrophil counts was also observed in TIA patients; however, the studied CHIs did not differ significantly from the control group. In IS patients, the NLR, NPR, and SIRI were significantly elevated compared to both the TIA group and controls. Conclusions. Marked increases in leukocytes, neutrophils, and monocytes, as well as elevated CHIs such as the neutrophil-to-lymphocyte ratio, neutrophil-to-platelet ratio, and systemic inflammatory response index, may indicate the development of cerebral infarction in the setting of ischemia and aid in the timely differential diagnosis between IS and TIA.