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

Abstract

BackgroundThe changes in the platelet-to-lymphocyte ratio (PLR) before and after recombinant tissue plasminogen activator (rtPA) treatment and the time point at which the PLR is a potentially valuable prognostic predictor in patients wit ischemic stroke remain largely unknown. Therefore, the purpose of this study was to explore the characteristics of the PLR and evaluate their effects on clinical outcomes before and 24 h after rtPA treatment.MethodsThis study included 741 consecutive patients with acute ischemic stroke who underwent intravenous thrombolysis with rtPA. We collected data on demographics, vascular risk factors, medication history, and other clinical information pertaining to all patients. Specifically, blood samples for PLR measurement were collected on admission and 24 h after stroke. The outcome was assessed by using the Modified Rankin Scale (mRS) at 3 months and whether death occurred within 3 months or not. Univariate and multivariate logistic regression analysis was used to assess the association of the PLR with the risks of poor outcome (mRS>2) and death. An individualized prediction model was established to predict poor outcome.ResultsOf the 741 patients, 255 (34.4%) had poor outcome, and 43 (5.8%) died. The PLR significantly increased 24 h after rtPA in patients with poor outcome and death. Logistic analysis revealed that higher PLR 24 h after rtPA was independently associated with increased risks of poor outcome and death. However, the PLR on admission was not associated with the risks of poor outcome and death. The individualized prediction model for poor outcome based on the 24-h PLR exhibited favorable discrimination (areas under the curves of the training and validation groups: 0.743 and 0.729, respectively), calibration (P > 0.05), and clinical usefulness.ConclusionsWe found the PLR to be a variable that potentially predicts the risks of poor outcome and death in patients with acute ischemic stroke 24 h after rtPA; however, it cannot make the same prediction on admission.

Blood-based biomarkers for prediction of 30-days mortality in patients with acute moderate and severe stroke in neurological intensive care unit: A prospective observational study

“…In this study, we rstly reported that IL-10, IL-6, NLR,TNF-α, lymphocytes, PPR, LMR, PCT, neutrophils, cerebral herniation and NIHSS were associated with 30-day mortality in moderate and severe stroke patients, suggesting a multi-marker approach to improve outcome prediction in stroke patients, which consistent with previous research [ 26] [27][28][29] [30] . Most of these blood-based biomarkers are related to in ammation, suggesting that an elevated in ammatory state contribute to the mortality in moderate and severe stroke patients.…”

The Association of the Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio and Systemic Inflammation Response Index with Short-Term Functional Outcome in Patients with Acute Ischemic Stroke

“… 25 A recent study found that PLR at 24 hours after thrombolysis was a marker of 3-month functional outcome in AIS patients. 26 To our knowledge, our study is the first to report the association of PLR with functional outcomes at discharge in AIS patients, and the finding is similar to the 90-day functional outcomes of previous studies.…”

Pan-Immune-Inflammatory Value Predicts the 3 Months Outcome in Acute Ischemic Stroke Patients after Intravenous Thrombolysis

“…This may be because the PIV data in this study came from laboratory data at the time of admission. It has been confirmed that the predictive power of inflammation indicators 24 hours after thrombolytic therapy was stronger than that at admission [ 24 ]. Compared to SII, NLR and PLR, PIV includes not only lymphocyte and platelet, but also monocyte and neutrophil, suggesting that PIV is a more systemic indicator of inflammation.…”