The association between platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, and carotid artery stenosis and stroke following carotid endarterectomy

Abstract

Objectives Platelet/lymphocyte ratio is considered to be a recent biomarker which is not only related with inflammation but also associated with the atherosclerotic process. In this study, we aimed to investigate the relationship between carotid artery stenosis, platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, and mean platelet volume in patients undergoing carotid endarterectomy. Methods A total of 160 patients (127 males, 33 females; mean age 69.98 ± 9.76 years; range 48–92 years), who were undergoing carotid endarterectomy due to severe carotid artery stenosis, were evaluated and compared with 201 patients (140 males, 61 females, mean age 66.30 ± 9.24 years, range 41–90 years) without severe carotid artery stenosis. The patients were divided into four groups with respect to the carotid artery stenosis as: Group I (<50% stenosis), Group II (50–70% stenosis), Group III (70–90% stenosis), and Group IV (90–99% stenosis). Results Platelet/lymphocyte ratio, neutrophil/lymphocyte ratio and mean platelet volume were found higher in Group IV (patients with severe carotid artery stenosis) (p < 0.01) and were positively correlated with the degree of stenosis (p < 0.01). Platelet/lymphocyte ratio is an independent predictor for post operative stroke (p = 0.047) at multivariate analysis. A threshold level of 145.304 of platelet/lymphocyte ratio combined with a sensitivity 83.3% and specificity 73.8% (95% CI, 0.802–0.921, area under the curve = 0.862 ± 0.03; p = 0.002) for the identification of post operative stroke. Conclusions This retrospective study suggests that platelet/lymphocyte ratio in the blood which was taken preoperatively could be considered as an additional, easy, and inexpensive method to predict a possible higher incidence of postoperative stroke after carotid endarterectomy.

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

“…In another study, high PLR values could indirectly estimate the infarcted size of stoke patients and the poor recanalization rate after thrombectomy therapy (13). Last, an increased PLR has also been shown to play an important role in postoperative stroke after carotid endarterectomy and the development of post-stroke depression (PSD) (37, 38). However, the association between PLR and the prognosis of AIS patients treated with IVT has not yet been studied.…”

Effect of systemic immune inflammation index on symptom development in patients with moderate to severe carotid stenosis

“…Similarly, there are some studies such as monitoring the severity of carotid artery disease and the development of symptoms, and predicting the development of stroke with the PLR value [20,21]. In addition to platelets, it has been shown that neutrophils and lymphocytes play a decisive role in the development of symptoms, especially in stroke, in patients under medical follow-up and in patients undergoing carotid endarterectomy [22]. In our study, we found that NLR and PLR values were correlated with symptom development.…”

Regarding “The association between platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, and carotid artery stenosis and stroke following carotid endarterectomy”

“…We read with great interest the recent publication of Des¸er et al reporting the association between platelet/ lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR), and carotid artery stenosis and stroke following carotid endarterectomy. 1 The authors found a significant correlation between the degree of ICA stenosis and the NLR (r ¼ 0.258, p < 0.01). Other studies have shown that the NLR was significantly higher in symptomatic patients with ICA stenosis compared to nonsymptomatic patients, 2,3 suggesting the interest of the NLR as a potential predictor for ICA plaques to become symptomatic.…”

“…4 The originality of the study published by Des¸er et al was to investigate the interest of the PLR as a predictive factor of the post-operative outcomes of patients undergoing endarterectomy. 1 Interestingly, they found that the PLR was an independent predictive factor of post-operative stroke (p ¼ 0.047). A PLR value >145.3 had a sensitivity and a specificity of 83.3% and 73.8%, respectively, to predict post-operative stroke.…”