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Platelet-to-neutrophil Ratio after Intravenous Thrombolysis Predicts Unfavorable Outcomes in Acute Ischemic Stroke

[ Vol. 17 , Issue. 4 ]

Author(s):

Mei-Qi Wang, Ying-Ying Sun, Yan Wang, Xiu-Li Yan, Hang Jin, Xin Sun, Peng Zhang, Hong-Jing Zhu, Zhen-Ni Guo* and Yi Yang*   Pages 411 - 419 ( 9 )

Abstract:


Background and Purpose: Platelet-to-neutrophil ratio (PNR) was suggested to be an independent protective predictor for 90-days outcomes in acute ischemic stroke (AIS) patients in previous studies. This study aims to investigate the association between PNR and outcomes of AIS in intravenous thrombolysis (IVT) group.

Methods: Data on acute ischemic stroke patients who received intravenous thrombolysis from April 2015 to March 2019 were collected. We defined the PNR value at admission as pre-IVT PNR and after IVT within 24 h was defined as post-IVT PNR. Clinical outcome indicators included early neurological deterioration (END), hemorrhagic transformation (HT), delayed neurological deterioration (DND), and poor 3-month outcome (3m-mRS >2).

Results: A total of 581 patients were enrolled in the final analysis. The age was 61(53-69) years, and 423(72.8%) were males. Post-IVT PNR was independently associated with hemorrhagic transformation (OR = 0.974; 95%CI = 0.956-0.992; P=0.006), early neurological deterioration (OR = 0.939; 95%CI = 0.913-0.966; P = 0.01), delayed neurological deterioration (OR = 0.949; 95%CI = 0.912- 0.988; P = 0.011), and poor outcome (OR = 0.962; 95%CI = 0.948-0.976; P<0.001). PNR level was identified as high (at the cut-off value or above) or low (below the cut-off value) according to receiver operating curve (ROC) analyses on each endpoint. Comparison of early neurological deterioration, hemorrhagic transformation, delayed neurological deterioration, and poor 3-month outcome (3m-mRS >2) between patients at high and low levels for platelet-to-neutrophil ratio (PNR) showed statistical differences (p<0.001).

Conclusion: Post-IVT PNR was independently associated with early neurological deterioration, hemorrhagic transformation, delayed neurological deterioration, and poor 3-month outcome. Lower PNR can predict a worse outcome.

Keywords:

Acute ischemic stroke, intravenous thrombolysis, early neurological deterioration, hemorrhagic transformation, delayed neurological deterioration.

Affiliation:

Department of Neurology, Stroke Center, Neuroscience Center, The First Hospital of Jilin University, Chang Chun, Jilin, Department of Neurology, Stroke Center, Neuroscience Center, The First Hospital of Jilin University, Chang Chun, Jilin, Department of Neurology, Stroke Center, Neuroscience Center, The First Hospital of Jilin University, Chang Chun, Jilin, Department of Neurology, Stroke Center, Neuroscience Center, The First Hospital of Jilin University, Chang Chun, Jilin, Department of Neurology, Stroke Center, Neuroscience Center, The First Hospital of Jilin University, Chang Chun, Jilin, Department of Neurology, Stroke Center, Neuroscience Center, The First Hospital of Jilin University, Chang Chun, Jilin, Department of Neurology, Clinical Trail and Research Center for Stroke, The First Hospital of Jilin University, Chang Chun, Jilin, Department of Neurology, Stroke Center, Neuroscience Center, The First Hospital of Jilin University, Chang Chun, Jilin, Department of Neurology, Clinical Trail and Research Center for Stroke, The First Hospital of Jilin University, Chang Chun, Jilin, Department of Neurology, Stroke Center, Neuroscience Center, The First Hospital of Jilin University, Chang Chun, Jilin



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