Objective::
Increased leukocyte count are positively associated with poor outcomes and all-cause mortality in coronary
heart disease, cancer, and ischemic stroke. The role of leukocyte count in acute ischemic stroke (AIS) remains important.
We aimed to investigate the association between admission leukocyte count before thrombolysis with recombinant
tissue plasminogen activator (rt-PA) and 3-month outcomes in AIS patients.
Methods::
This retrospective study included consecutive AIS patients who received intravenous (IV) rt-PA within 4.5 h of
symptom onset between January 2016 and December 2018. We assessed outcomes including short-term hemorrhagic transformation
(HT), 3-month mortality, and functional independence (modified Rankin Scale [mRS] score of 0–2 or 0–1).
Results::
Among 579 patients who received IV rt-PA, 77 (13.3%) exhibited HT at 24 h, 43 (7.4%) died within 3 months, and
211 (36.4%) exhibited functional independence (mRS score: 0–2). Multivariable logistic regression revealed admission leukocyte
count as an independent predictor of good and excellent outcomes at 3 months. Each 1-point increase in admission
leukocyte count increased the odds of poor outcomes at 3 months by 7.6% (mRS score: 3–6, odds ratio (OR): 1.076, 95%
confidence interval (CI): 1.003–1.154, p=0.041) and 7.8% (mRS score: 2–6, OR: 1.078, 95% CI: 1.006–1.154, p=0.033).
Multivariable regression analysis revealed no association between HT and 3-month mortality. Admission neutrophil and
lymphocyte count were not associated with 3-month functional outcomes or 3-month mortality.
Conclusion::
Lower admission leukocyte count independently predicts good and excellent outcomes at 3 months in AIS patients
undergoing rt-PA treatment.
Low-Dose Versus Standard-Dose Tissue Plasminogen Activator for Intravenous Thrombolysis in Asian Acute Ischemic Stroke Patients
