Introduction: Inflammation is associated with the initiation and progression of cardiovascular diseases. The neutrophil-to-lymphocyte ratio (NLR) has recently emerged as a prognostic marker in cardiovascular diseases. However, impact of NLR on the functional outcome in patients with ischemic stroke remains unclear.
Hypothesis: The aim of the study was to investigate the prognostic role of the NLR in patients with acute ischemic stroke.
Methods: A consecutive 1,113 patients who were admitted within 7 days after ischemic stroke onset between March 2010 and December 2014 were included for analysis. The patients were categorized into tertiles on the basis of NLR. We evaluated the short-term outcomes using a modified Rankin Scale (mRS) at three-months after onset of ischemic stroke. We divided patients into two groups with favorable outcome (mRS score ≤2) and unfavorable outcome (mRS score ≥3). We compared the clinical characteristics and NLR between two groups.
Results: From all the patients included in this study (mean age, 67.8 years; men, 60.0%), 284 (25.5%) patients had unfavorable outcome. The patients with unfavorable outcome were older and more likely to have atrial fibrillation, history of previous stroke, and diabetes mellitus. In addition, participants with unfavorable outcome tended to have lower body mass index and higher initial NIHSS. The percentage values of the tertile 3 were significantly higher in the unfavorable outcome group (28.3% vs. 47.9%, P < 0.001). After adjustment for covariates, the highest tertile were at an exaggerated risk for unfavorable outcome [Odds ratio (95% confidence interval); tertile 3, 1.75 (1.17 - 2.63), P = 0.007].
Conclusions: This study demonstrated that higher NLR predicted worse outcome at 3 months following acute ischemic stroke. This suggests that NLR could be a useful and reliable prognostic biomarker following acute ischemic stroke.