Carotid artery stenosis (CAS) is primarily caused by atherosclerotic plaque. Progressive inflammation may contribute to the rupture of an atherosclerotic plaque. The platelet-to-lymphocyte ratio (PLR) is a new and simple marker that indicates inflammation. In this study, we aimed to investigate the use of the PLR to determine the severity of CAS. One hundred forty patients were chosen from among patients who underwent carotid angiography in our institution. Symptomatic patients with stenosis >50% in the carotid arteries and asymptomatic patients with stenosis >80% were diagnosed via carotid angiography as having critical stenosis. Patients were classified into two groups. Group 1 included patients who had critical CAS, whereas Group 2 included patients with noncritical CAS, as determined by carotid angiography. Correlations between the PLR and the severity of CAS were analyzed. There were no significant differences in sex and age between the two groups. The PLR was 162.5 ± 84.7 in the noncritical CAS group patients and 94.9 ± 60.3 in the critical CAS group patients (p < 0.0001). The PLR value of 117.1 had 89% sensitivity and 68% specificity for CAS [95% confidence interval, 0.043-0.159; area under the curve, 0.101 ± 0.03)]. In this study, we have shown that PLR values may be associated with critical stenosis in at least one of the carotid arteries. Furthermore, PLR values may be used to predict critical stenosis in the carotid arteries.
Background: The prognostic value of the neutrophil–lymphocyte ratio (NLR) in ischemic stroke remains debated due to cohort variability and treatment heterogeneity across studies. This study evaluates the relationship between admission NLR, stroke severity and 90-day outcomes in patients with anterior circulation large vessel occlusion (LVO) undergoing early, successful revascularization. Methods: A retrospective multicenter study was conducted with 1082 patients treated with mechanical thrombectomy for acute ischemic stroke. The relationship between admission NLR, baseline National Institutes of Health Stroke Scale (NIHSS), 24 h NIHSS and 90-day modified Rankin Scale (mRS) outcomes was analyzed using logistic regression. Results: Admission NLR correlated weakly but significantly with both baseline (p = 0.018) and 24 h (p = 0.005) NIHSS scores, reflecting stroke severity. However, multivariate analysis showed that higher 24 h NIHSS scores (OR 0.831, p = 0.000) and prolonged puncture-to-recanalization times (OR 0.981, p = 0.000) were independent predictors of poor 90-day outcomes, whereas NLR was not (p = 0.557). Conclusions: Admission NLR is associated with stroke severity but does not independently predict clinical outcomes at 90 days in patients achieving early and successful revascularization. These findings underscore the critical role of inflammation in the acute phase of stroke but suggest that its prognostic value for long-term outcomes is limited in this context.
Background: Stroke remains a leading cause of morbidity and mortality worldwide, with dyslipidemia playing a crucial role in atherosclerosis and stroke development. The Atherogenic Index of Plasma (AIP), calculated as log(triglyceride/HDL), has emerged as a biomarker for atherosclerosis and cardiovascular risk. However, its relationship with stroke prognosis remains unclear. This study aimed to investigate the association between AIP and favorable clinical outcomes at three months in acute ischemic stroke patients undergoing mechanical thrombectomy. Methods: We conducted a retrospective analysis of 222 patients who underwent mechanical thrombectomy between December 2019 and April 2023. The association between AIP and demographic variables, etiology, successful recanalization, intracerebral hemorrhage, and three-month mRS was evaluated. AIP values were compared between patients with good (mRS 0–2) and poor (mRS 3–6) clinical outcomes. Results: The most common comorbidity was hypertension (72.1%), followed by AF (50%). Stroke etiologies included large artery atherosclerosis (16.2%), cardioembolism (57.2%), and undetermined causes (26.6%). AIP values were significantly lower in patients with good functional outcomes. Additionally, AIP values were inversely associated with AF but positively correlated with DM and previous stroke history. No significant relationship was observed between the AIP and successful recanalization or intracerebral hemorrhage. Conclusions: This study is the first to demonstrate that elevated AIP is associated with poor functional outcomes after three months in patients undergoing mechanical thrombectomy. Given its strong correlation with prognosis, the AIP may serve as a valuable biomarker for identifying high-risk patients. Future prospective studies are needed to further validate these findings and explore the potential role of the AIP in stroke management.
1 January 2020 in Revista da Associação Médica Brasileira
SUMMARY ABSTRACT The COVID-19 infection that started in the Wuhan Province of the People's Republic of China and has now spread throughout the world is not limited to the respiratory system, but also causes other systemic symptoms through viremia. Recent data show that the central and peripheral nervous system involvement is particularly substantial. Thus, the present study aims to investigate the current neurological comorbidities and symptoms of patients with COVID-19 who were followed up by our clinic physicians.