The relationship between the platelet to leukocyte ratio and mechanical thrombectomy outcomes in acute ischemic stroke patients

ABSTRACT

Background and purpose

The predictive effect of blood cell ratio on ischemic event has been widely confirmed. Whether PWR and PNR can assess the risk of endovascular treatment (EVT) is largely unclear. This study aimed to investigate the prognostic value of PNR and PWR in acute ischemic stroke patients treated with EVT.

Methods

Poor functional outcome was defined as Modified Rankin Scale (mRS) of 3-6 at 3 months, Symptomatic intracranial hemorrhage (sICH) was diagnosed based on CT scan and classified according to the criterial of Heidelberg Bleeding Classification. Binary logistical regression was used to analyze the relationship of PWR, PNR with functional outcome and symptomatic intracranial hemorrhage (sICH).

Results

Patients with good prognosis had higher PNR and PWR value (29 vs. 24, P=0.002) (22 vs. 19, P=0.009), a lower rate of sICH (2.9% vs. 24.9%, P<0.001). In model 1, the lower PNR significantly associated with poor functional outcome (OR, 0.48; 95% CI 0.26-0.88; P=0.018), and sICH (OR, 0.42; 95% CI 0.19-0.91; P=0.028). The lower PWR only significantly associated with poor prognosis (OR, 0.97; 95% CI 0.94-1.00; P=0.038), and had a trend relation with sICH (OR, 0.98; 95% CI 0.94-1.02; P=0.328). In model 2 lower PNR still significantly associated with poor functional outcome (OR, 0.53; 95% CI 0.29-0.99; P=0.047), but showed a trend for predicting sICH (OR, 0.56; 95% CI 0.25-1.25; P=0.158).

Conclusion

Platelet to leukocyte ratio may be use to assess the risk of functional outcome and sICH in patients with acute anterior circulation occlusion stroke undergoing endovascular treatment in real world China.

KEYWORDS:

• Ischemic stroke
• endovascular treatment
• PNR
• PWR
• sICH
• prognosis

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This study was partly supported by National Natural Science Foundation of China (No. 81530038, 81400993 and 81671172), National Key Research and Development Program (No. 2017YFC1307901) and Chinese Postdoctoral Science Fund (No. 2015M572815).

Notes on contributors

Ling Wang

Ling Wang, Master student of Jinling Hospital affiliated to Nanjing University. Now working in the Department of Neurology, the Fourth Affiliated Hospital of Anhui Medical University. The main research area is intravascular treatment of cerebrovascular disease. Has published several articles in related fields in domestic and foreign journals.

Qiantao Cheng

Qiantao Cheng, MD, PhD, now serves as the chief physician of the Department of Neurology, the Fourth Affiliated Hospital of Anhui Medical University. Has published 30 papers in domestic and international core journals.

Min Peng

Min Peng, Master student of Jinling Hospital affiliated to Nanjing University, the main research area is dietry inflmmatory and cerebrovascular diseases.

Daping Lv

Daping LV, MD, Chief physician of Department of Neurology, the Fourth Affiliated Hospital of Anhui Medical University, the main research area is cerebrovascular disease intervention. Has published 20 papers in domestic and international core journals.

Wenjie Zi

Wenjie Zi, MD, PhD,  neurologist of Xinqiao Hospital and The Second Affiliated Hospital, Army Medical University (Third Military Medical University) of China, The main research area is intravascular treatment of cerebrovascular disease.

Gelin Xu

Gelin Xu, Doctor of Medicine, Chief Physician of Department of Neurology, Nanjing General Hospital of Nanjing Military Region, Deputy Director of Department, Supervisor of Doctoral Candidate. Mainly engaged in the research of cerebrovascular disease and intravascular intervention technology, learning and memory disorders and dementia, sleep and mood disorders. He has published more than 50 papers in international SCI cited journals. He served as a member of the Cerebrovascular Diseases Group of Jiangsu Province and a member of the Military Psychiatric Association. Associate editor of the International Journal Interventional Neurology.

Xinfeng Liu

Xinfeng Liu, MD of the University of Lausanne, Switzerland, postdoctoral fellow of the University of Minnesota, is currently the director of the Department of Neurology at the Nanjing General Hospital of the Nanjing Military Region, chief physician, director, professor and doctoral supervisor of the Department of Neurology, School of Medicine, Nanjing University. Committed to neurology and cerebrovascular intervention diagnosis and treatment, through technical innovation, device research and development, clinical path reform to overcome many clinical problems, is my country's leading expert in the field of cerebrovascular disease and cerebrovascular intervention. Good at cerebrovascular disease, cerebrovascular intervention and stroke risk control, etiology diagnosis and treatment of various cerebrovascular diseases, stroke unit treatment, carotid and cerebral artery stenosis or occlusion diagnosis, cerebrovascular angioplasty and intravascular stent treatment.