{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T08:14:24Z","timestamp":1783757664486,"version":"3.55.0"},"reference-count":43,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100009592","name":"Beijing Municipal Science and Technology Commission, Adminitrative Commission of Zhongguancun Science Park","doi-asserted-by":"publisher","award":["Z241100009024046"],"award-info":[{"award-number":["Z241100009024046"]}],"id":[{"id":"10.13039\/501100009592","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Novel composite inflammatory markers' role in stroke prognosis is understudied, and the best predictor is unclear, requiring further exploration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to systematically evaluate the associations of 6 novel composite inflammatory markers on stroke prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Based on the Third China National Stroke Registry (CNSR\u2010III), we analyzed 14,476 participants aged \u2265\u200918\u2009years with ischemic stroke or transient ischemic attack. Novel composite inflammatory markers were calculated, including neutrophil\u2010to\u2010lymphocyte ratio (NLR), platelet\u2010to\u2010lymphocyte ratio (PLR), monocyte\u2010to\u2010lymphocyte ratio (MLR), systemic immune\u2010inflammation index (SII), systemic inflammatory response index (SIRI), and pan\u2010immune inflammation value (PIV). Outcomes at 1\u2009year included stroke recurrence (primary outcome) and ischemic stroke, composite vascular events, mortality, and poor functional outcome (mRS 2\u20136) as secondary outcomes. Multivariable Cox or logistic regression analyses were performed to estimate the association of composite inflammatory markers with these outcomes. XGBoost, IDI, and NRI were utilized to evaluate predictive performance. Additionally, subgroup analyses and sensitivity tests were conducted to assess the robustness of the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 1403 (9.7%), 1300 (9.0%), 1484 (10.3), 483 (3.3%) and 2865 (21.7%) patients with recurrent stroke, ischemic stroke, composite vascular events, mortality, and poor functional outcome within 1\u2009year. SII, PIV, PLR, NLR, SIRI, and MLR were positively associated with stroke recurrence, with hazard ratios (95% CIs) of highest\u2010quartile vs. lowest\u2010quartile 1.39 (1.20, 1.61), 1.40 (1.21, 1.62), 1.16 (1.00, 1.34), 1.42 (1.22, 1.66), 1.38 (1.18, 1.61) and 1.18 (1.02, 1.37), respectively. A graded increase in stroke risk across quartiles was observed (Log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). All six markers were positively associated with ischemic stroke, composite vascular events, mortality, and poor functional outcome. SIRI demonstrated better predictive performance [IDI: 0.004 (0.002, 0.007); NRI: 0.082 (0.052, 0.107)] than the other five composite inflammatory markers for stroke recurrence. Among eight XGBoost models, the AUC increased from 0.598 (base) to 0.610 (adding NIHSS\/mRS), and further to 0.624 with the addition of SIRI, which was the highest.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Novel composite inflammatory markers were significantly associated with an increased risk of adverse outcomes in stroke patients. When accounting for the influence of inflammatory markers, SIRI demonstrated stronger predictive ability for stroke recurrence than the other markers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70473","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T07:55:46Z","timestamp":1783756546000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictive Value of Composite Inflammatory Markers for Stroke Prognosis: A Prospective Cohort Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4845-6049","authenticated-orcid":false,"given":"Bing","family":"Wu","sequence":"first","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie\u2010Jie","family":"Li","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9822-5758","authenticated-orcid":false,"given":"Jing","family":"Jing","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin\u2010Xi","family":"Lin","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xia","family":"Meng","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7700-6054","authenticated-orcid":false,"given":"Yong","family":"Jiang","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong\u2010Jun","family":"Wang","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1608-1856","authenticated-orcid":false,"given":"Hong\u2010Qiu","family":"Gu","sequence":"additional","affiliation":[{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,11]]},"reference":[{"issue":"10","key":"e_1_2_13_2_1","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1016\/S1474-4422(24)00369-7","article-title":"Global, Regional, and National Burden of Stroke and Its Risk Factors, 1990\u20132021: A Systematic Analysis for the Global Burden of Disease Study 2021","volume":"23","author":"GBD 2021 Stroke Risk Factor Collaborators","year":"2024","journal-title":"Lancet Neurology"},{"issue":"23","key":"e_1_2_13_3_1","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.124.036142","article-title":"Projections of the Stroke Burden at the Global, Regional, and National Levels up to 2050 Based on the Global Burden of Disease Study 2021","volume":"13","author":"Cheng Y.","year":"2024","journal-title":"Journal of the American Heart Association"},{"issue":"7","key":"e_1_2_13_4_1","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1038\/nm.2399","article-title":"The Immunology of Stroke: From Mechanisms to Translation","volume":"17","author":"Iadecola C.","year":"2011","journal-title":"Nature Medicine"},{"issue":"6","key":"e_1_2_13_5_1","doi-asserted-by":"crossref","first-page":"2777","DOI":"10.1172\/JCI135530","article-title":"Immune Responses to Stroke: Mechanisms, Modulation, and Therapeutic Potential","volume":"130","author":"Iadecola C.","year":"2020","journal-title":"Journal of Clinical Investigation"},{"issue":"16","key":"e_1_2_13_6_1","doi-asserted-by":"crossref","first-page":"7928","DOI":"10.3390\/ijms26167928","article-title":"Immunological and Inflammatory Biomarkers in the Prognosis, Prevention, and Treatment of Ischemic Stroke: A Review of a Decade of Advancement","volume":"26","author":"Iordache M. 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