Ozge Altintas1, Mehmet Ozgen Altintas2, Abdurrahman Tasal3, Okkes Taha Kucukdagli4, Talip Asil5. 1. a Nigde Bor State Hospital, Neurology Clinic , Nigde , Turkey. 2. b Faculty of Engineering, Department of Genetics and Bioengineering , Fatih University , Istanbul , Turkey. 3. c Medicalpark Tarsus Hospital, Cardiology Clinic , Mersin , Turkey. 4. d Bakirkoy Dr. Sadi Konuk Education and Training Hospital, Emergency Clinic , Istanbul , Turkey. 5. e Medical Faculty, Department of Neurology , Bezmi Alem Vakıf University , Istanbul , Turkey.
Abstract
OBJECTIVES: Of all strokes, 85% are ischemic and intracranial artery occlusion accounts for 80% of these ischemic strokes. Endovascular therapy for acute ischemic stroke was a new modality aiming at resolution of clots in occluded cerebral arteries. The platelet-to-lymphocyte ratio (PLR) was introduced as a potential marker to determine increased inflammation, which is a result of releasing many mediators from the platelets. In this study we aimed to evaluate whether the PLR had a prognostic role in stroke patients undergoing thrombectomy and attempted to determine the effect that this ratio had on their survival. METHODS: Over a three-year period, demographic, clinical, and angiographic findings of 57 consecutive patients with acute ischemic stroke who underwent mechanical thrombectomy were evaluated. RESULTS: The patients were divided into two groups on the basis of a PLR level cut-off value of 145 based on receiver operating characteristic (ROC) curve. Successful revascularization (mTICI 2b and 3) was achieved in 42 of 57 (73.7%) patients; a mTICI 3 state was observed in 21 of 23 patients with low-PLR values (p = .015). Patients with higher PLR values had significantly a score of less than six on the ASPECT scale compared to patients with lower PLR values (p = .005). The patients with low-PLR values had better functional outcomes (mRS ≤ 2) compared with the patients with high-PLR values [respectively, p = .004 (at first month) and p = .014 (at third month)]. DISCUSSION: The platelet-to-lymphocyte ratio could represent pro-thrombotic inflammatory state in acute ischemic stroke patients because having a high-PLR values increased the poor prognosis, the rate of insufficient recanalization, and the size of infarcted area.
OBJECTIVES: Of all strokes, 85% are ischemic and intracranial artery occlusion accounts for 80% of these ischemic strokes. Endovascular therapy for acute ischemic stroke was a new modality aiming at resolution of clots in occluded cerebral arteries. The platelet-to-lymphocyte ratio (PLR) was introduced as a potential marker to determine increased inflammation, which is a result of releasing many mediators from the platelets. In this study we aimed to evaluate whether the PLR had a prognostic role in strokepatients undergoing thrombectomy and attempted to determine the effect that this ratio had on their survival. METHODS: Over a three-year period, demographic, clinical, and angiographic findings of 57 consecutive patients with acute ischemic stroke who underwent mechanical thrombectomy were evaluated. RESULTS: The patients were divided into two groups on the basis of a PLR level cut-off value of 145 based on receiver operating characteristic (ROC) curve. Successful revascularization (mTICI 2b and 3) was achieved in 42 of 57 (73.7%) patients; a mTICI 3 state was observed in 21 of 23 patients with low-PLR values (p = .015). Patients with higher PLR values had significantly a score of less than six on the ASPECT scale compared to patients with lower PLR values (p = .005). The patients with low-PLR values had better functional outcomes (mRS ≤ 2) compared with the patients with high-PLR values [respectively, p = .004 (at first month) and p = .014 (at third month)]. DISCUSSION: The platelet-to-lymphocyte ratio could represent pro-thrombotic inflammatory state in acute ischemic strokepatients because having a high-PLR values increased the poor prognosis, the rate of insufficient recanalization, and the size of infarcted area.
Entities:
Keywords:
Acute stroke; Endovascular treatment; Patient outcome; Platelet/lymphocyte ratio
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