Higher Platelet-to-Lymphocyte Ratio Is Associated With Worse Outcomes After Intravenous Thrombolysis in Acute Ischaemic Stroke

Xu, Jinzhang; He, Xianghuo; Li, Qiang; Liu, Jian-Ren; Zhuang, Mei-Ting; Huang, Feifei; Bao, Gang

doi:10.3389/fneur.2019.01192

Cited by 52 publications

(48 citation statements)

References 46 publications

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“…The PLR was demonstrated to be an independent predictor of diabetes with chronic complications [38][39][40] and tumors (such as non-small-cell lung cancer and hypopharyngeal squamous cell carcinoma) [41,42]. Recent studies proved that PLR is related to the prognosis of stroke thrombolysis [43] or endovascular treatment [44]. However, we did not find a significant correlation between PLR and unfavorable functional prognosis or adverse events in AIS patients.…”

Section: Plos Onecontrasting

confidence: 66%

The correlation between novel peripheral blood cell ratios and 90-day mortality in patients with acute ischemic stroke

et al. 2020

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Background We aimed to investigate the correlation between the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelet-to-neutrophil ratio (PNR), platelet-to-white blood cell ratio (PWR) and 90-day mortality in patients with acute ischemic stroke (AIS). Methods We retrospectively included 633 patients with AIS from January 2017 to May 2018. The correlation between each indicator and the degree of neurologic deficit was assessed. Kaplan-Meier survival curves based on blood cell ratios were used to analyze the 90-day survival rate of patients with AIS. Results A total of 663 patients with AIS were enrolled, of which 24 (3.6%) experienced recurrence and 13 (2.0%) died. NLR>3.23 (odds ratio; OR = 2.236; 95% confidence interval [CI], 1.472-3.397; P<0.001), PNR<31.14 (OR = 0.471; 95% CI, 0.297-0.749; P = 0.001), and PWR<20.62 (OR = 0.498; 95% CI, 0.309-0.800; P = 0.004) were associated with an unfavorable 90-day prognosis. NLR>3.23, PWR<20.62, and PNR<31.14 were associated with an increased risk of 90-day mortality. Conclusion PNR, PWR, and NLR were associated with the 90-day mortality of patients with AIS. Patients with high NLRs or low PWRs and PNRs may have a greater risk of mortality than other patients. These clinical indicators may help clinicians judge unfavorable prognosis early and implement the appropriate interventions.

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Section: Plos Onecontrasting

confidence: 66%

The correlation between novel peripheral blood cell ratios and 90-day mortality in patients with acute ischemic stroke

et al. 2020

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“…With the exception of total lymphocytes, the imbalance between circulating neuroprotective and neurotoxic T lymphocyte subsets also affects prognosis in AIS. Decreasing circulating Tregs and increasing Th17 has been shown to contribute to poor prognosis in AIS [23][24][25][26][27][28][29]. IL-2 functions as a multilineage lymphocyte growth factor to promote the proliferation and differentiation of naive CD4+ T cells.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of plasma IL-2 and sIL-2Rα in patients with first-ever ischaemic stroke

Zhao

Huang

et al. 2020

J Neuroinflammation

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Background: An imbalance between circulating neuroprotective and neurotoxic T cell subsets leads to poor prognosis in acute ischaemic stroke (AIS). Preclinical studies have indicated that the soluble form of the interleukin-2 receptor α (sIL-2Rα)-IL-2 complex regulates T cell differentiation. However, the association between sIL-2Rα levels and AIS remains unclear. Methods: A total of 201 first-ever AIS patients within 24 h after stroke onset and 76 control subjects were recruited. The National Institutes of Health Stroke Scale (NIHSS) score and 3-month functional outcome (modified Rankin Scale [mRS] score) at admission were assessed. Plasma sIL-2Rα and IL-2 levels at admission were measured. Prognostic significance was identified by using univariate and multivariate logistic regression analyses. Results: Patients with poor functional outcomes at 3 months had significantly higher levels of sIL-2Rα and lower levels of IL-2 than patients with good outcomes. Moreover, sIL-2Rα levels showed a strong positive correlation with NIHSS and mRS scores (p < 0.0001), whereas IL-2 levels were negatively correlated with mRS scores (p < 0.01). Univariate analyses showed that higher sIL-2Rα and IL-2 levels were associated with an increased and reduced risk of unfavourable outcomes, respectively. After adjusting for confounding variables, the sIL-2Rα level remained independently associated with an increased risk of an unfavourable outcome, and adding sIL-2Rα levels to the conventional risk factor model significantly improved risk reclassification (net reclassification improvement 17.56%, p = 0.003; integrated discrimination improvement 5.78%, p = 0.0003). Conclusions: sIL-2Rα levels represent a novel, independent prognostic marker that can improve the currently used risk stratification of AIS patients. Our findings also highlight that elevated plasma sIL-2Rα and IL-2 levels manifested opposite correlations with functional outcome, underlining the importance of IL-2/IL-2R autocrine loops in AIS.

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“…Platelet-to-lymphocyte ratio (PLR), as a combination of platelets and lymphocytes, is a new biomarker to re ect the thrombus formation pathway and in ammation pathway. Several pieces of evidence have con rmed that PLR was a potential marker to predict increased in ammation, the risk of myocardial infarction and ischemic stroke [7][8][9][10][11][12]. However, the predictive value of PLR on the outcomes of ischemic stroke with rtPA treatment are largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Platelet-to-lymphocyte ratio at 24h after thrombolysis is a prognostic marker in acute ischemic stroke patients

Sun¹,

Wang²,

Wang³

et al. 2020

Preprint

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Introduction: The role of Platelet-to-lymphocyte ratio (PLR) in outcomes of acute ischemic stroke, especially before and after intravenous thrombolysis with recombinant tissue plasminogen activator (rtPA), has not been elucidated. Thus, the aim of this study was to evaluate the effect of PLR before and after rtPA on clinical outcomes.Methods: A total of 582 consecutive patients who had acute ischemic stroke diagnosed and received intravenous thrombolysis with rtPA were included in this study. We collected demographics, vascular risk factors, previous history of drugs and other clinical information for all patients. Specifically, blood samples for PLR values were collected on admission and at 24 hours after stroke. Multivariate logistic regression analysis was used to assess the association between PLR with the risk of poor outcome (mRS≥3), death and hemorrhagic transformation (HT). Results: Of 582 patients, 191 (32.8%) had a poor outcome, 40 (6.9%) died and 82 (14.1%) had HT. After adjustment for potential confounders, multivariate logistic regression analysis showed that higher PLR at 24h after rtPA was independently associated with an increased risk of poor outcome (OR=1.004; 95% CI:1.001-1.007; P=0.009) and the occurrence of death (OR=1.009; 95% CI:1.004-1.013; P<0.001), but not associated with the risk of HT (OR=1.003; 95% CI:0.999-1.007; P=0.165). In addition, PLR on admission was not associated with the risk of poor outcome, death and HT (all P>0.05).Conclusions: We found that PLR at 24h after rtPA can predict the risk of poor outcome and death in acute ischemic stroke patients, but PLR on admission cannot.

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Higher Platelet-to-Lymphocyte Ratio Is Associated With Worse Outcomes After Intravenous Thrombolysis in Acute Ischaemic Stroke

Cited by 52 publications

References 46 publications

The correlation between novel peripheral blood cell ratios and 90-day mortality in patients with acute ischemic stroke

The correlation between novel peripheral blood cell ratios and 90-day mortality in patients with acute ischemic stroke

Prognostic significance of plasma IL-2 and sIL-2Rα in patients with first-ever ischaemic stroke

Platelet-to-lymphocyte ratio at 24h after thrombolysis is a prognostic marker in acute ischemic stroke patients

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