Increased Neutrophil-to-lymphocyte Ratios are Associated with Greater Risk of Hemorrhagic Transformation in Patients with Acute Ischemic Stroke

Song, Quhong; Li, Yisong; Wang, Yanan; Wei, Chuanliang; Liu, Junfeng; Liu, Ming

doi:10.2174/1567202616666181204122457

Cited by 24 publications

(22 citation statements)

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“…Of the remaining 26 articles, 19 were removed due to being reviews ( n = 3) and not reporting relevant outcomes ( n = 16). Seven articles were eventually included in our meta‐analysis (Duan et al, ; Goyal et al, ; Guo et al, ; Maestrini et al, ; Malhotra et al, ; Pikija et al, ; Song et al, ).…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, Guo et al () proved that NLR is a dynamic variable, and its variation is associated with HT after thrombolysis in AIS with a high cutoff value of 10.59, which had a high area under the curve (AUC) of 0.814 and a high sensitivity of 76.5%. Song and colleagues also demonstrated that a higher NLR with a cutoff value of 4.5 (sensitivity 64.8% and specificity 60.1%) is associated with a greater risk of HT in patients with AIS (Song et al, ). A subgroup analysis in our study showed that the risk of HT in AIS patients with an NLR cutoff value of 7.5–11 was 7.93 times higher than that of the control group.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that the NLR is independently associated with clinical outcomes and short‐term mortality in patients with AIS (Gokhan et al, ; Tokgoz, Keskin, Kayrak, Seyithanoglu, & Ogmegul, ; Yu et al, ; Zhang et al, ). In addition, it was reported that a higher admission NLR is an independent risk factor for HT and 3‐month functional outcome in patients with AIS both with and without reperfusion therapy (Duan et al, ; Goyal et al, ; Guo et al, ; Maestrini et al, ; Pikija et al, ; Song et al, ). The subject of our study was to comprehensively summarize the value of NLR for predicting HT in patients with AIS by performing a meta‐analysis.…”

Section: Introductionmentioning

confidence: 99%

“…outcomes (n = 16). Seven articles were eventually included in our meta-analysis (Duan et al, 2018; Goyal et al, 2018; Guo et al, 2016;Maestrini et al, 2015;Malhotra et al, 2018;Pikija et al, 2018;Song et al, 2018).…”

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Neutrophil‐to‐lymphocyte ratio predicts hemorrhagic transformation in ischemic stroke: A meta‐analysis

Zhang

Xiao-dong

et al. 2019

Brain and Behavior

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Introduction The neutrophil‐to‐lymphocyte ratio (NLR) has been shown to be a marker associated with inflammation and is independently associated with the adverse clinical outcomes of symptomatic intracranial hemorrhage, cancer, and cardiovascular disease. Hemorrhagic transformation (HT) is a serious complication of ischemic cerebral infarction and can be intensified by therapeutic interventions for acute ischemic stroke (AIS). The purpose of our research was to explore the predictive effect of NLR for HT in patients with AIS and to determine the best predictive value. Methods PubMed, Web of Science, EMBASE, MEDLINE, Cochrane, and Google Scholar were searched. The primary endpoint was HT, and subgroup analysis was performed. Review Manager software version 5.3 was used to statistically analyze the outcomes. Results A total of seven studies including 3,726 patients met the inclusion criteria. The pooled odds ratio (OR) value of the high NLR that predicted HT in AIS patients was 1.53 (95% CI, 1.21–1.92; p = .0003). In addition, 1.10 (95% CI, 1.05–1.15; p < .0001) was the pooled OR of the high NLR associated with increased 3‐month mortality in patients with AIS. In the subgroup analysis with an NLR cutoff value of 7.5–11, the correlation between NLR above the cutoff value and the rate of HT in patients with AIS was statistically significant (OR, 7.93; 95% CI, 2.25–27.95; p = .001). Conclusion A high NLR can predict HT and 3‐month mortality in patients with AIS. Regardless of the country of origin and the sampling time, an NLR with a cutoff value of 7.5–11 was independently associated with HT in AIS patients.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

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Neutrophil‐to‐lymphocyte ratio predicts hemorrhagic transformation in ischemic stroke: A meta‐analysis

Zhang

Xiao-dong

et al. 2019

Brain and Behavior

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“…In addition, stroke led to reduced WM integrity of the IC correlating with a contralateral deteriorations in motor function commonly seen in patients post-stroke (30, 76, 77). Also similar to human stroke patients, MCAO led to an acute immune response marked by an increase in circulating neutrophils and a corresponding decrease in circulating lymphocytes which is a key biomarker for identifying ischemic stroke patients at risk for the development of intracranial hemorrhage thus influencing the use of tPA (78–80). Functional assessments showed impaired behavior and motor function disruptions that affected both spatiotemporal parameters and weight distribution, all of which parallel clinical functional outcomes in stroke patients (81–83).…”

Section: Discussionmentioning

confidence: 99%

Acute characterization of tissue and functional deficits in a clinically translatable pig model of ischemic stroke

Kaiser

Waters

Fagan

et al. 2019

Preprint

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35The acute stroke phase is a critical time frame used to evaluate stroke severity, therapeutic 36 options, and prognosis while also serving as a major target for the development of diagnostics. To 37 better understand stroke pathophysiology and to enhance the development of treatments, our group 38 developed a translational pig ischemic stroke model. In this study, the evolution of acute ischemic 39 stroke tissue damage, immune response, and functional deficits were further characterized in the 40 pig model. Stroke was induced by middle cerebral artery occlusion in Landrace pigs. At 24 hours 41 post-stroke, magnetic resonance imaging revealed a decrease in ipsilateral diffusivity and an 42 increase in hemispheric swelling and intracranial hemorrhage resulting in notable midline shift. 43 Stroke negatively impacted white matter integrity leading to decreased fractional anisotropy. 44 Similar to acute clinical patients, stroked pigs showed a reduction in circulating lymphocytes and 45 a surge in neutrophils and band cells. Functional responses corresponded with structural changes 46 with reduced exploration in open field testing and impairments in spatiotemporal gait parameters. 47 This novel, acute ischemia characterization provides important insights into tissue and functional 48 level changes in a pig model that can be used to identify treatment targets and future testing of 49 therapeutics and diagnostics. 50 51 Keywords: brain ischemia, gait analysis, magnetic resonance imaging, porcine, acute stroke 52 53 54 3 3 55

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Characterization of tissue and functional deficits in a clinically translational pig model of acute ischemic stroke

et al. 2020

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Increased Neutrophil-to-lymphocyte Ratios are Associated with Greater Risk of Hemorrhagic Transformation in Patients with Acute Ischemic Stroke

Cited by 24 publications

References 0 publications

Neutrophil‐to‐lymphocyte ratio predicts hemorrhagic transformation in ischemic stroke: A meta‐analysis

Neutrophil‐to‐lymphocyte ratio predicts hemorrhagic transformation in ischemic stroke: A meta‐analysis

Acute characterization of tissue and functional deficits in a clinically translatable pig model of ischemic stroke

Characterization of tissue and functional deficits in a clinically translational pig model of acute ischemic stroke

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