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ABSTRACT
Background: To determine the correlation of inflammatory and platelet volume indices with the severity of stroke and 3-month clinical outcomes in patients with acute ischemic stroke (AIS) after endovascular thrombectomy (EVT).
Methods: A retrospective analysis was conducted for AIS patients who underwent EVT at our hospital from 2015 to 2019. Inflammatory factors, including white blood count, neutrophil count, lymphocyte count, neutrophil to lymphocyte ratio (NLR), high-sensitivity C-reactive protein (hs-CRP), procalcitonin (PCT) and interleukin-6 (IL-6), and platelet volume indices, including platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW) and MPV/PC levels were assessed. Results were analyzed between patients with favorable and unfavorable outcomes at 3 months post-EVT.
Results: A total of 257 AIS patients were included in the study. There were 86 (33.5%) patients with favorable functional outcomes at 3 months. Compared to patients with favorable outcomes, those with poor outcomes have lower lymphocyte count, higher neutrophil count and NLR levels. There were no differences in hs-CRP,PCT and IL-6 between the two groups. The correlation analysis showed that the increase in MPV, PDW, and MPV/PC was related to the high level of the NIHSS score at admission. Multivariate logistic regression analysis showed that higher NLR levels are an independent risk factor for unfavorable outcomes at 3 months (OR = 1.141; 95% CI 1.061 to 1.227, P = 0.000).
Conclusions: MPV, PDW, and MPV/PC are associated with stroke severity. Higher NLR levels upon admission may predict unfavorable functional outcomes in patients with AIS after undergoing EVT.Abbreviations ACA: anterior cerebral artery; AIS: acute ischemic stroke; ASPECTS: alberta stroke program early CT score; BMI: body mass index; DBP: diastolic blood pressure; END: early neurological deterioration; EVT: endovascular thrombectomy; hs-CRP: high-sensitivity C-reactive protein; HT: hemorrhagic transformation; ICA: internal carotid artery; IL-6: interleukin-6; IS: ischemic progression; LAA: Large-Artery Atherosclerosis; MCA: middle cerebral artery; MPV: mean platelet volume; mTICI: modified thrombolysis in cerebral infarction; NIHSS: National Institute of Health stroke scale; NLR: neutrophil to lymphocyte ratio; OTP: onset-to-puncture; PC: platelet count; PCT: procalcitonin; PDW: platelet distribution width; SBP: systolic blood pressure; sICH: symptomatic intracerebral hemorrhageWBC: white blood cell.
Author contributions
All authors contributed significantly to this work. Z.Y.C. and Y.Y.S. designed the research study. Z.Y.C., Y.B.H., Y.J.S., Y.B.Z., and H.B.C performed the research study and collected the data; Z.Y.C. and Y.B.H. analyzed the data; Z.Y.C. and Y.B.H. wrote the first draft of the manuscript; and Y.Y.S. revised the manuscript. All authors reviewed and approved the manuscript.
Compliance with ethical standards
Conflict of interest The authors declare that they have no conflict of interest.
Ethical approval
Our study was conducted in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Xuan Wu Hospital.
Informed consent
The informed consent requirement was waived due to the retrospective study design.
Disclosure statement
No potential conflict of interest was reported by the authors.
Additional information
Notes on contributors
Zhongyun Chen
Zhongyun Chen, is a medical student. He is studying for a Ph.D. degree in the Department of Neurology, Xuanwu Hospital, Capital Medical University.
Yanbo He
Yanbo He, is a neurologist with a Ph.D. degree in neurology. She is an associate chief physician in the Department of Neurology, The Beijing Moslem People Hospital. She is specialized in severe neurological diseases.
Yingying Su
Yingying Su, is is a neurologist in Beijing Xuanwu Hospital, advisor of Ph.D. and M.D. of Capital Medical University. She has several publications in clinical research of severe neurologic diseases, such as massive cerebral infarction, status epilepticus, and brain death.
Yijia Sun
Yijia Sun, is a medical student. She is studying for a master's degree in the Department of Neurology, Xuanwu Hospital, Capital Medical University.
Yingbo Zhang
Yingbo Zhang, is a neurologist with a Ph.D. degree in neurology. She is a medical doctor in the Department of Neurology, Beijing Tsinghua Changgung Hospital Affiliated to Tsinghua University. She is specialized in severe neurological diseases.
Hongbo Chen
Hongbo Chen, is a neurologist with a master's degree in neurology. He is an associate chief physician in the Department of Neurology, Liangxiang Hospital of Beijing Fangshan District. He is specialized in cerebrovascular diseases and severe neurological diseases.