Abstract Background and aims Inflammatory activity contributes to clinical instability in atherosclerotic carotid stenosis (aCS). However, the prognostic value of complete blood counts (CBCs) and CBC-derived inflammatory indices in patients treated with percutaneous angioplasty (PTA) remains unclear. We evaluated their association with symptomatic status and periprocedural complications. Methods We retrospectively analysed symptomatic and asymptomatic patients with severe (≥70%) aCS treated with PTA between 01/092024-30/09/2025. Absolute CBC values and derived inflammatory indices were assessed preprocedurally, using European reference intervals for CBCs and intracohort quartiles for derived indices. Univariable and multivariable logistic regression analyses assessed associations with symptomatic presentation and 30-day composite major complications. Results Eighty-one patients were included (36/45 female/male; median age 72 IQR 11 years; 42 symptomatic); the composite periprocedural complication rate was 11% (9/81). Most absolute CBC parameters and CBC-derived indices were not associated with symptomatic status; however, the highest-quartile monocyte-dominant indices (Monocyte-to-Lymphocyte Ratio, Systemic Inflammation Response Index, Aggregate Index of Systemic Inflammation) were more frequent among symptomatic patients (each OR 3.06, p=0.042), while Platelet-to-Monocyte Ratio was inversely associated (OR 0.19, p=0.005). The presence of any monocyte-dominant index in the upper quartile remained associated with symptomatic presentation after multivariable adjustment (aOR 3.89, p=0.026). For periprocedural complications, eosinophil out-of-reference-interval status (OR 5.83, p=0.035) and the highest-quartile Neutrophil-to-Lymphocyte-Platelet Ratio were associated in univariable analyses (OR 5.58, p=0.023); after adjustment for age and sex, only eosinophil abnormality remained independently associated (aOR 5.40, p=0.046). Conclusions CBC-derived inflammatory markers, particularly monocyte-dominant indices and eosinophil abnormalities, may aid low-cost risk stratification in aCS patients undergoing PTA. Conflict of interest Péter Pál Böjti: nothing to disclose. Martina Zsófia Madari: nothing to disclose. Viktor Balogh: nothing to disclose. Aldea Cristina Caterina: nothing to disclose. Mohammed Salman: nothing to disclose. Máté Pásztor: nothing to disclose. Máté Kondor: nothing to disclose. Péter Orosz: nothing to disclose. Lőrincz Velkey: nothing to disclose. Zoltán Simony: nothing to disclose. Zoltán Kővári: nothing to disclose. Zsolt Berentei: nothing to disclose. István Szikora: nothing to disclose. Sándor Nardai: nothing to disclose
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Péter Pál Böjti
Semmelweis University
Martina Madari
Semmelweis University
Viktor Balogh
Semmelweis University
European Stroke Journal
Semmelweis University
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Böjti et al. (Fri,) studied this question.
synapsesocial.com/papers/69fd7fcdbfa21ec5bbf08631 — DOI: https://doi.org/10.1093/esj/aakag023.919