Eosinophil-to-Monocyte Ratio is a Potential Predictor of Prognosis in Acute Ischemic Stroke Patients After Intravenous Thrombolysis

Abstract

Background Eosinophil and monocyte have been demonstrated separately to be independent predictors of acute ischemic stroke (AIS). This study aimed to evaluate the association between eosinophil-to-monocyte ratio (EMR) and 3-month clinical outcome after treatment with recombinant tissue plasminogen activator (rt-PA) for AIS patients. Simultaneously, we made a simple comparison with other prognostic indicators, such as 24h neutrophil-to-lymphocyte ratio (NLR) and 24h platelet-to-lymphocyte ratio (PLR) to investigate the prognostic value of EMR. Methods and Results A total of 280 AIS patients receiving intravenous thrombolysis were retrospectively recruited for this study. Complete blood count evaluations for EMR were conducted on 24 hours admission. The poor outcome at 3-month was defined as the modified Rankin Scale (mRS) of 3–6 and the mRS score for death was 6. The EMR levels in patients with AIS were lower than those in the healthy controls and showed a negative correlation with the NIHSS score. At the 3-month follow-up, multivariate logistic regression analysis indicated an association among EMR, poor outcome and mortality. In addition, EMR had a higher predictive ability than popular biomarkers like NLR and PLR for 3-month mortality. Conclusion The lower levels of EMR were independently associated with poor outcome and dead status in AIS patients.

Relationship Between the Eosinophil/Monocyte Ratio and Prognosis in Decompensated Heart Failure: A Retrospective Study

“… 9 Another study indicated that the EMR can predict prognosis and functional outcomes in patients with ischemic stroke. 7 , 8 Inflammatory factors are thought to be involved in the occurrence and progression of ischemic CV disease, and the level of inflammation is related to its prognosis. 19 Clinical studies have shown that the use of inflammatory inhibitors can improve the prognosis of patients with ischemic CV disease.…”

“…10 The eosinophil count was determined using an automatic blood cell analyzer, and the baseline EMR was calculated according to the following formula: absolute eosinophil value (×10 9 /L)/absolute monocyte value (×10 9 /L). 8 …”

“…Circulating eosinophils contain many cytoplasmic particles that are effective mediators of antibacterial immunity, but they are extremely toxic to heart cells; thus, these particles participate in the cardiac decompensation process. 6 The eosinophil/monocyte ratio (EMR) is a new type of inflammatory marker, 7 , 8 and it can be used to predict the prognosis of cardiovascular (CV) disease with associated underlying inflammation. For example, evidence suggests that the EMR can predict the incidence of major CV events in patients with acute coronary syndrome.…”

“… 9 Moreover, the EMR is associated with the prognosis and functional outcomes of patients with ischemic stroke. 7 , 8 However, the value of the EMR for predicting the prognosis of decompensated HF is unknown. Therefore, the aim of this study was to evaluate the relationship between the EMR and the prognosis of decompensated HF using a retrospective analysis.…”

Monocyte, Neutrophil and Whole Blood Transcriptome Dynamics Following Ischemic Stroke

“…An increase of circulating neutrophils occurs promptly after stroke, and altered ratios of peripheral leukocytes (including neutrophils and monocytes) are indicators of outcome [12][13][14][15][16][17]. Successful intervention strategies in the acute and subacute phases of stroke may be improved when the pathological role of specific leukocyte types at different times is considered.…”