A Novel Predictive Marker for In-Hospital Mortality in Acute Cerebral Infarction: Low-Density Lipoprotein Cholesterol to Lymphocyte Ratio

Abstract

Objectives Neutrophil to eosinophil ratio, neutrophil to lymphocyte ratio, C-reactive protein to albumin ratio, and red blood cell distribution width (RDW) have been studied in patients with acute cerebral infarction (ACI). However, the low-density lipoprotein cholesterol (LDL-C) to lymphocyte ratio has never been studied. Hence, our objective was to study the LDL-C to lymphocyte ratio with regard to in-hospital mortality rates of patients with ACI. Materials and methods We retrospectively examined our patients diagnosed with ACI between January 2015 and December 2018. The patients' clinical data and imaging and laboratory results during the acute period were retrieved from our database and saved for statistical analysis. The receiver operating characteristic (ROC) curve analysis was performed to evaluate the predictive value of the variables and to calculate the cut-off values. Results A total of 172 patients with ACI, including 43 patients who died and 129 patients who survived in the hospital, were included in the study. The median age of the patients who died was significantly higher than that of those who survived (p: <0.001). Median triglyceride level, LDL-C to lymphocyte ratio, and RDW-SD values were significantly higher in patients who died (p = 0.017, p: <0.001, and p = 0.003, respectively). Areas under the ROC curve were found to be as follows: LDL-C to lymphocyte ratio: 0.774 (95% CI: 0.697-0.851), RDW-SD: 0.562 (95% CI: 0.456-0.669), and triglyceride level: 0.621 (95% CI: 0.531-0.732). The cut-off value of the LDL-C to lymphocyte ratio was 59.71 (sensitivity: 79.1%; specificity: 58.1%). Conclusions The LDL-C to lymphocyte ratio can be used as a marker to predict in-hospital mortality in patients with ACI. We recommend further studies to verify our findings.

The Relationship of Low-Density-Lipoprotein to Lymphocyte Ratio with Chronic Obstructive Pulmonary Disease

“…Previously, LLR was used as a new predictor of in-hospital mortality of acute cerebral infarction. 6 A few previous population-based studies have found that cerebrovascular disease is a common comorbidity in patients with COPD. [30][31][32] Therefore, we consider applying LLR, a meaningful index in cerebral infarction, to COPD to observe whether it has indicative significance.…”

“… 4 COPD is a chronic inflammation characterized by an increase in the number of alveolar macrophages, neutrophils and cytotoxic T lymphocytes, as well as the release of a variety of inflammatory mediators (lipids, chemokines, cytokines, growth factors) and high levels of oxidative stress. 5 Güneş et al 6 found that the ratio of low-density-lipoprotein to lymphocyte is a new predictor of in-hospital mortality of acute cerebral infarction. Besides, the exacerbation of COPD is associated with a variety of infiltrating cells, especially lymphocytes, as well as a variety of enzymes (neutrophil elastase and MMP-9) and cytokines (CXCL8, TNF-ɑ) in sputum and bronchoalveolar lavage (BAL) fluid.…”