Neutrophil‐to‐lymphocyte ratio and its changes predict the 3‐month outcome and mortality in acute ischemic stroke patients after intravenous thrombolysis

Abstract

Background and purposeThe neutrophil‐to‐lymphocyte ratio (NLR) has been demonstrated as a prognostic inflammatory biomarker in ischemic stroke. The study aimed to investigate the association of NLR and its dynamic change with long‐term outcome and mortality in acute ischemic stroke (AIS) patients who received intravenous thrombolysis (IVT).MethodsFrom a prospective cohort, AIS patients receiving IVT (alteplase, 0.9 mg/kg) with complete NLR data were retrospectively screened. Based on 3‐month modified Rankin scale score (mRS), patients were classified into good group (mRS 0–1) and poor outcome group (mRS 2–6), or survival group (mRS 0–5) and death group (mRS 6). Multivariate logistic regression analysis and receiver operating curve were used to identify prognostic factors and their predictive powers.ResultsA total of 259 eligible patients were enrolled in our study. Logistic regression analysis showed that NLR at 24 h (adjusted odds ratio [aOR] 1.182), 12 days (aOR 1.218) after IVT was independent predictors of 3‐month outcome with the AUC of 0.815, 0.820, respectively, whereas NLR at 24 h (aOR 1.17), 12 days (aOR 1.252) after IVT and percentage changes of NLR between admission and 24 h after IVT (aOR 1.214), and between admission and 12 days after IVT (aOR 1.233) were independent predictors of 3‐month mortality with the AUCs of 0.86, 0.902, 0.814, and 0.855, respectively.ConclusionThe comprehensive report suggests that NLR and its dynamic changes are associated with 3‐month outcome and mortality in AIS patients after IVT with good predictive powers.

Relationship of neutrophil/lymphocyte ratio with cerebral small vessel disease and its common imaging markers

“…14,15 NLR is significantly associated with the development of inflammatory diseases, including CSVD. [16][17][18][19][20][21][22][23][24][25] The existing literature 26,27 has demonstrated a relationship between the net quantities of neutrophils and lymphocytes and cardiovascular disease. In comparison to individual blood indices like total white blood cell count or neutrophil count, the NLR is deemed to have a better predictive ability for cardiovascular disease.…”

“…Lymphocytes secrete anti‐inflammatory cytokines, such as interleukin‐4 (IL‐4), IL‐10, and IL‐13, and promote the production of nerve growth factors and remodeling and repair of ischemic brain tissue 14,15 . NLR is significantly associated with the development of inflammatory diseases, including CSVD 16–25 . The existing literature 26,27 has demonstrated a relationship between the net quantities of neutrophils and lymphocytes and cardiovascular disease.…”