Relation Between Neutrophil Lymphocyte Ratio, Brain Imaging and Carotid Duplex Findings in Acute Ischemic Stroke.

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Yosria AlTaweel ◽  
Rania Nageeb ◽  
Pakinam Metwally ◽  
Ahmed Badawy
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Brain Imaging ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Carotid Duplex

scholarly journals The Association of Neutrophil-Lymphocyte Ratio, Platelet-Lymphocyte Ratio and Lymphocyte-Monocyte Ratio With Post-Thrombolysis Early Neurological Outcomes in Patients With Acute Ischemic Stroke

2020 ◽  
Author(s):  
Pengyu Gong ◽  
Yukai Liu ◽  
Yachi Gong ◽  
Gang Chen ◽  
Xiaohao Zhang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Characteristic Curve ◽  
Intravenous Thrombolysis ◽  
Nihss Score ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Neurological Outcomes ◽  
Platelet Lymphocyte Ratio ◽  
Cell Counts

Abstract Background and Purpose: To investigate the association of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) with post-thrombolysis early neurological outcomes including early neurological improvement (ENI) and early neurological deterioration (END) in patients with acute ischemic stroke (AIS).Methods: AIS patients undergoing intravenous thrombolysis were enrolled from April 2016 to September 2019. Blood cell counts were sampled before thrombolysis. Post-thrombolysis END was defined as National Institutes of Health Stroke Scale (NIHSS) score increase of ≥4 within 24 hours after thrombolysis. Post-thrombolysis ENI was defined as NIHSS score decrease of ≥4 or complete recovery within 24 hours. Multivariable logistic regression analyses were performed to explore the relationship of NLR, PLR and LMR to post-thrombolysis END and ENI. We also used receiver operating characteristic curve analysis to assess the discriminative ability of three ratios in predicting END and ENI.Results: Among 1060 recruited patients, a total of 193 (18.2%) were diagnosed with ENI and 398 (37.5%) were diagnosed with END. Multivariable logistic models indicated that NLR (odds ratio [OR], 1.652; 95% confidence interval [CI] 1.510-1.807, P=0.001) and PLR (OR, 1.015; 95% CI 1.012-1.018, P=0.001) were independent factors for post-thrombolysis END. Moreover, NLR (OR, 0.686; 95% CI 0.631-0.745, P=0.001), PLR (OR, 0.997; 95% CI 0.994-0.999, P=0.006) and LMR (OR, 1.170; 95% CI 1.043-1.313, P=0.008) served as independent factors for post-thrombolysis ENI. Area under curve (AUC) of NLR, PLR and LMR to discriminate END were 0.763, 0.703 and 0.551, respectively. AUC of NLR, PLR and LMR to discriminate ENI were 0.695, 0.530 and 0.547, respectively.Conclusions: NLR and PLR were associated with and may predict post-thrombolysis END. NLR, PLR and LMR were related to post-thrombolysis ENI.

Abstract TP225: Coated-Platelet Levels Are Associated With Chronic Hyperglycemia and Systemic Inflammation in Acute Ischemic Stroke

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Debarti Ray ◽  
Eleanor A Matthews ◽  
George L Dale ◽  
Bappaditya Ray ◽  
Calin I Prodan
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Lymphocyte Count ◽  
Retrospective Chart Review ◽  
Entire Group ◽  
Large Artery ◽  
Linear Regression Models ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Chronic Hyperglycemia

Introduction: Elevated levels of coated-platelets (a subset of procoagulant platelets) are often associated with acute ischemic stroke (AIS). Diabetes mellitus (DM) and chronic inflammation are both known risks factor for AIS. Elevated neutrophil-lymphocyte-ratio (NLR) and platelet-lymphocyte-ratio (PLR) are also often seen in the setting of acute myocardial infarction and AIS. However, the relationship between prothrombotic, dysglycemic and proinflammatory states in AIS is incompletely characterized. Hypothesis: To investigate whether elevated coated-platelet levels in AIS patients with chronic hyperglycemia is associated with proinflammatory states. Methods: The present cohort consists of patients with AIS or transient ischemic attack (TIA) due to large-artery disease over the period of one year. Coated-platelet levels were assayed upon admission. Glycated hemoglobin (HbA1c) and leukocyte count with differential were obtained through retrospective chart review. Study population was subcategorized into DM (HbA1c >6.4 and/or history of DM), prediabetic (PD, HbA1c 5.7-6.4) and non-diabetic (ND, HbA1c <5.7). Inter-relationship was assessed using linear regression models. Results: We recruited 47 AIS/TIA patients, with an average age of 67.3±8.1 years and 17/47 (36.2%) being current smokers. Thirty of 47 patients (63.8%) were diabetic with 23 patients having HbA1c levels >6.4. Higher coated-platelet levels were associated with higher lymphocyte count for the entire group (r=+0.375; p=0.0094) and also for the patients with HbA1c >6.4 (r=+0.516; p=0.012; n=23). Although PLR and HbA1c >6.4 showed a positive correlation (r=+0.42; p=0.046; n=23) in DM patients, this was not observed among DM patients with HbA1c <6.4. Conclusion: Our study demonstrates positive correlations between elevated coated-platelets and lymphocyte count and between PLR and HbA1c in AIS/TIA patients with HbA1c >6.4. This alludes to a synergistic role for procoagulant and proinflammatory states in chronically dysglycemic AIS/TIA patients.

scholarly journals Prognostic role of neutrophil–lymphocyte ratio in patients with acute ischemic stroke

Medicine ◽  
2017 ◽  
Vol 96 (45) ◽  
pp. e8624 ◽  
Author(s):  
Jing Zhang ◽  
Qingqing Ren ◽  
Yanlin Song ◽  
Min He ◽  
Yunhui Zeng ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Prognostic Role ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

scholarly journals KORELASI ANTARA RASIO NEUTROFIL LIMFOSIT DENGAN VOLUME INFARK SEREBRI PADA PENDERITA STROKE ISKEMIK AKUT

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Ilsa Hunaifi ◽  
Triana Dyah Cahyawati
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Infarct Volume ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Cross Sectional Design

 CORRELATION BETWEEN NEUTROFIL LIMPHOCYTE RATIO AND CEREBRAL INFARCTION VOLUME IN ACUTE ISCHAEMIC STROKEABSTRACTIntroduction: Inflammation plays a key role in stroke pathophysiology. Neutrophils is one of the earliest leucocyte subtypes to infiltrate the ischemia area of the brain. The neutrophil-lymphocyte ratio (NLR) is independent of the severity of coronary heart disease and as a predictor of poor clinical outcomes in patients with coronary heart disease undergoing angiography. The neutrophil-lymphocyte ratio values may be a prognostic factor in ischemic stroke patients. The neutrophil- lymphocyte ratio values can also be used in predicting infarct size, however limited study has been conducted in this area.Aim: To determine the correlation of NLR with cerebral infarct volume in acute ischemic stroke patients.Method: This was an analytical observational study with cross sectional design. The population for this study were acute ischemic stroke patients at NTB Genereal Hospital. The collected data were analyzed by Spearman correlation test.Results: Approximately 52 participants  were enrolled in this study with mean age was 59.79±8.65 years old. Hypertension was a common modifiable risk factor identified in more than 94.2 % participant. The mean of neutrophil lymphocyte ratio was 3.94±2.96 and mean of infarct volume was 13.96±37.26cm3. There was correlation between RNL and cerebral infract volume (r=+0.351; p=0.023).Discussions: Higher lymphocyte neutrophil ratio in acute ischemic stroke patients would result in an increase of brain infarct volume.Keyword: Infarct volume, ischaemic stroke, neutrophil lymphocyte ratioABSTRAKPendahuluan: Inflamasi memegang peranan penting dalam patofisiologi stroke. Salah satu subtipe dari sel leukosit yang paling awal menginfiltrasi ke area iskemia di otak adalah neutrofil. Rasio neutrofil limfosit (RNL) merupakan faktor independen terhadap beratnya penyakit jantung koroner dan sebagai prediktor luaran klinis yang buruk pada penderita penyakit jantung koroner yang menjalani angiografi. Nilai RNL dapat menjadi faktor prognostik pada penderita stroke iskemik. Nilai RNL juga bisa digunakan dalam memprediksi ukuran infark namun belum dilakukan penelitian hingga saat ini.Tujuan: Mengetahui korelasi RNL dengan volume infark serebri pada penderita stroke iskemik akut.Metode: Penelitian analitik observasional dengan desain potong lintang terhadap pasien stroke iskemik akut di RSUP NTB. Data yang terkumpul dianalisis dengan uji korelasi Spearman.Hasil: Didapatkan 52 subjek dengan rerata umur 59,79±8,65 tahun dan faktor risiko utama hipertensi (94,2%). Didapatkan rerata rasio neutrofil limfosit 3,94±2,96 dan rerata volume infark 13,96±37,26cm3. Terdapat korelasi antara RNL dengan volume infark serebri (r=+0,351; p=0,023).Diskusi: Semakin tinggi nilai rasio neutrofil limfosit mengakibatkan semakin luasnya volume infark serebri pada penderita stroke iskemik akut.Kata kunci: Rasio neutrofil limfosit, stroke iskemik, volume infark  

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