Monocyte/lymphocyte ratio is associated with carotid stenosis in ischemic stroke: A retrospective analysis

Zuo, Bo; Zhu, Sha; Meng, Xue; Zhao, Danhua; Zhang, Jun

doi:10.1002/brb3.1429

Cited by 27 publications

(18 citation statements)

References 29 publications

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“…In another study, Ahbap et al observed higher NLR among dipper versus non dipper hypertensives with CKD supporting our results. The MLR is rapidly emerging as another important marker of vascular inflammation has been linked to carotid stenosis severity in ischaemic stroke and to the severity of coronary disease and cardiovascular mortality [28][29][30]. There was no association between PLR and either blood pressure dipping status or MACE in our cohort.…”

Section: Discussionmentioning

confidence: 57%

The relationship between ambulatory arterial stiffness, inflammation, blood pressure dipping and cardiovascular outcomes

Boos

Toon

Almahdi

2021

BMC Cardiovasc Disord

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Background The ambulatory arterial stiffness index (AASI) is an indirect measure of arterial stiffness obtained during ambulatory blood pressuring monitoring (ABPM). Its relationship to nocturnal blood pressure dipping status and major adverse cardiovascular events (MACE) are controversial and its association with vascular inflammation has not been examined. We aimed to investigate the relationship between the AASI, inflammation and nocturnal blood pressure dipping status and its association with MACE. Methods Adults (aged 18–80 years) who underwent 24-h ABPM for the diagnosis of hypertension or its control were included. The inflammatory markers measured were the neutrophil–lymphocyte (NLR), platelet-lymphocyte (PLR) and monocyte-lymphocyte ratios (MLR). The primary MACE was a composite of cardiovascular death, acute limb ischaemia, stroke or transient ischaemic attack (TIA) or acute coronary syndrome. Results A total of 508 patients (51.2% female) aged 58.8 ± 14.0 years were included; 237 (46.7%) were normal-dippers (≥ 10% nocturnal systolic dip), 214 (42.1%) were non-dippers (0–10% dip) and 57 (11.2%) were reverse-dippers (< 0% dip). The AASI was significantly higher among reverse (0.56 ± 0.16) and non-dippers (0.48 ± 0.17) compared with normal dippers (0.39 ± 0.16; p < 0.0001) and correlated with the NLR (r = 0.20; 95% CI 0.11 to 0.29: < 0.0001) and systolic blood pressure dipping % (r = − 0.34; − 0.42 to − 0.26: p < 0.0001). Overall 39 (7.7%) patients had ≥ 1 MACE which included a total of seven cardiovascular deaths and 14 non-fatal strokes/TIAs. The mean follow up was 113.7 ± 64.0 weeks. Increasing NLR, but not AASI or systolic dipping, was independently linked to MACE (overall model Chi-square 60.67; p < 0.0001) and MLR to cardiovascular death or non-fatal stroke/TIA (overall model Chi-square 37.08; p < 0.0001). Conclusions In conclusion AASI was associated with blood pressure dipping and chronic inflammation but not independently to MACE. The MLR and NLR were independent predictors of MACE.

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Section: Discussionmentioning

confidence: 57%

The relationship between ambulatory arterial stiffness, inflammation, blood pressure dipping and cardiovascular outcomes

Boos

Toon

Almahdi

2021

BMC Cardiovasc Disord

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“…And those cutoffs are 0.24 in men and 0.20 in women. In other researches on the predictive capability of MLR, an optimal cutoff point for predicting carotid artery stenosis in ischemic stroke population is 0.20 ( 13 ), and that for predicting long-term major adverse cardiac event in non–ST-elevated myocardial infarction patients is 0.31 ( 12 ). The cutoff point calculated in this article for predicting arterial stiffness is at a low level in the current study to predict various clinical events.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the count of cells, the ratios between them, such as neutrophil-to-lymphocyte ratio (NLR) ( 7 ), monocyte-to-lymphocyte ratio (MLR) ( 8 ), and platelet-to-lymphocyte ratio (PLR) ( 9 ), are also considered to reflect the inflammation degree. Verdoia et al ( 10 ) found that in people receiving coronary angiography, NLR was independently related to the prevalence and severity of coronary heart disease, and PLR ( 11 ) had a similar effect too; MLR could be an independent predictor of the severity of carotid artery stenosis in patients with ischemic stroke, and it can effectively reflect the severity of coronary artery disease better than NLR ( 12 , 13 ), which diseases are serious adverse events of arterial stiffness. Therefore, we hypothesized that leukocyte counts, platelet counts, and their ratios as indicators of inflammation might be related to arterial stiffness.…”

Section: Introductionmentioning

confidence: 99%

The Leukocyte Subtype Counts and Ratios Can Effectively Predict the Risk of Arterial Stiffness Assessed by Cardio-Ankle Vascular Index: A Retrospective Study

Wang

Bai

et al. 2021

Front. Cardiovasc. Med.

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Background: Arterial stiffness was the pathological basis and risk factor of cardiovascular diseases, with chronic inflammation as the core characteristic. We aimed to analyze the association between the arterial stiffness measured by cardio-ankle vascular index (CAVI) and indicators reflecting the inflammation degree, such as count of leukocyte subtypes, platelet, and monocyte-to-lymphocyte ratio (MLR), etc.Methods: The data of inpatients from November 2018 to November 2019 and from December 2019 to September 2020 were continuously collected as the training set (1,089 cases) and the validation set (700 cases), respectively. A retrospective analysis of gender subgroups was performed in the training set. The association between inflammatory indicators and CAVI or arterial stiffness by simple linear regression, multiple linear regression, and logistic regression was analyzed. The effectiveness of the inflammation indicators and the CAVI decision models to identify arterial stiffness by receiver operating curve (ROC) in the training and validation set was evaluated.Results: The effect weights of MLR affecting the CAVI were 12.87% in men. MLR was the highest risk factor for arterial stiffness, with the odds ratio (95% confidence interval) of 8.95 (5.04–184.79) in men after adjusting the covariates. A cutpoint MLR of 0.19 had 70% accuracy for identifying arterial stiffness in all participants. The areas under the ROC curve of the CAVI decision models for arterial stiffness were >0.80 in the training set and validation set.Conclusions: The MLR might be a high-risk factor for arterial stiffness and could be considered as a potential indicator to predict arterial stiffness.

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“… 17 , 18 For example, the higher MLR value of ischemic stroke patients is related to the degree of carotid artery stenosis and it is an independent risk factor for carotid artery stenosis. 19 It is also associated with stroke-related pneumonia (SAP), which is helpful for clinicians to establish an early diagnosis for patients with high-risk SAP. 20 Moreover, studies have found MLR values to be elevated in patients with affective disorders or schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

Monocyte-to-Lymphocyte Ratio is Associated with Depression 3 Months After Stroke

Ding¹,

Lai²,

Yang³

et al. 2021

NDT

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To explore the relationship between the monocyte-to-lymphocyte ratio (MLR) and depression three months after acute ischemic stroke. Patients and Methods: From May 2013 to September 2014, 203 patients with acute ischemic stroke were recruited within 7 days post-stroke from Shanghai Ruijin Hospital and blood samples were collected after admission. The Hamilton Depression Scale and Clinical Review were evaluated at 3 months after stroke. Based on the Diagnostic and Statistical Manual of Mental Disorders-IV diagnostic criteria, we divided patients into post-stroke depression (PSD) and non-PSD groups. We analyzed the intergroup difference in MLR and the contributing factors. Moreover, dynamic changes in monocytes, lymphocytes and MLR at four different time intervals for all the stroke patients and their relationship with PSD patients were also studied. Results: The NIHSS scores and MLR in the PSD group were significantly higher than in the non-PSD group (p<0.05). Logistic regression analysis revealed MLR was an independent risk factor for PSD (odds ratio: 18.020, 95% confidence interval: 1.127-288.195, p=0.041). MLR correlated negatively with cholesterol and low-density lipoprotein (r=−0.160 and −0.165, respectively, p<0.05). Within 7 days post-acute ischemic stroke, monocytes gradually increased while lymphocytes remained unchanged for all the stroke patients. The MLR value was significantly higher in the PSD group than in the non-PSD group within 24 h post-stroke (p<0.05), but there was no difference in the other three time-intervals between the two groups. Conclusion: The admission MLR, particularly within 24 h post-stroke, was associated with PSD at 3 months, implying that the MLR might be involved in the PSD inflammatory mechanism.

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Monocyte/lymphocyte ratio is associated with carotid stenosis in ischemic stroke: A retrospective analysis

Cited by 27 publications

References 29 publications

The relationship between ambulatory arterial stiffness, inflammation, blood pressure dipping and cardiovascular outcomes

The relationship between ambulatory arterial stiffness, inflammation, blood pressure dipping and cardiovascular outcomes

The Leukocyte Subtype Counts and Ratios Can Effectively Predict the Risk of Arterial Stiffness Assessed by Cardio-Ankle Vascular Index: A Retrospective Study

Monocyte-to-Lymphocyte Ratio is Associated with Depression 3 Months After Stroke

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