Abstract
Background: Studies assessing the prognostic effect of inflammatory markers of blood cells on the outcomes of patients with acute ischemic stroke treated with endovascular treatment (EVT) are sparse. We evaluated whether the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) affect reperfusion status in patients receiving EVT. Methods: Using a multicenter registry database, 282 patients treated with EVT were enrolled in this study. The primary outcome measure was unsuccessful reperfusion rate after EVT defined by thrombolysis in cerebral infarction grades 0–2a. Logistic regression analysis was performed to analyze the association between NLR/PLR and unsuccessful reperfusion rate after EVT. Results: Both NLR and PLR were higher in the unsuccessful reperfusion group than in the successful reperfusion group (p < 0.001). Multivariate analysis showed that both NLR and PLR were significantly associated with unsuccessful reperfusion (adjusted odds ratio (95% confidence interval): 1.11 (1.04–1.19), PLR: 1.004 (1.001–1.01)). The receiver operating characteristic curve showed that the predictive ability of both NLR and PLR was close to good (area under the curve (AUC) of NLR: 0.63, 95% CI (0.54–0.72), p < 0.001; AUC of PLR: 0.65, 95% CI (0.57–0.73), p < 0.001). The cutoff values of NLR and PLR were 6.2 and 103.6 for unsuccessful reperfusion, respectively. Conclusion: Higher NLR and PLR were associated with unsuccessful reperfusion after EVT. The combined application of both biomarkers could be useful for predicting outcomes after EVT.
Highlights
We aimed to evaluate the association between neutrophil-to-lymphocyte ratio (NLR)/platelet-to-lymphocyte ratio (PLR) and reperfusion rate and final infarct volume after endovascular treatment (EVT) using a multicenter database, thereby exploring the practical utility of these markers in predicting post-EVT outcomes
Multivariate analysis showed that both NLR and PLR were significantly associated with unsuccessful reperfusion (adjusted odds ratios (ORs): 1.11 (1.04–1.19), PLR: 1.004 (1.001–1.01))
We can speculate that higher NLR and PLR may be associated with an increased risk of unsuccessful reperfusion
Summary
Since reperfusion is known to be a key factor in determining the outcome of patients with acute ischemic stroke [4], evaluating markers to predict reperfusion status after EVT could allow clinicians to raise interest in real-world practice of EVT. Inflammatory response is one of the major pathophysiological mechanisms that cause atherosclerosis, and several circulatory inflammatory markers are known to be commonly activated in acute cerebral infarction [5,6,7,8,9]. Novel biomarkers that reflect the baseline inflammatory process in patients with ischemic stroke are widely used in studies to predict the prognosis of several subjects with cerebrovascular disease [16,17,18,19]
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