title: Can the Neutrophil-to-Lymphocyte Ratio Appropriately Predict Carotid Artery Stenosis in Patients with Ischemic Stroke?-A Retrospective Study.
abstract: BACKGROUND
  Carotid stenosis is a risk factor in ischemic stroke. Although C-reactive protein, interleukin-6, and tumor necrosis factor-alpha are known to predict carotid atherosclerosis, they are difficult to obtain in clinical practice. By studying the association between neutrophil-to-lymphocyte ratio (NLR) and carotid artery intima-media thickening (IMT) in patients with ischemic stroke, we determined that the NLR can predict carotid stenosis.
  
  
  METHODS
  We selected 252 patients with acute to subacute ischemic stroke who underwent carotid ultrasonography and complete and differential blood cell count tests. We collected data on sex, age, body mass index (BMI), alcohol consumption, smoking, hypertension, diabetes mellitus, dyslipidemia, and heart disease. Male and female patients were analyzed separately. We divided the subjects into 2 groups according to carotid IMT, and compared baseline characteristics and NLR between the 2 groups. The regression analysis was adjusted for confounding factors such as age, BMI, NLR, smoking, alcohol consumption, and a medical history of hypertension, diabetes mellitus, dyslipidemia, or heart disease.
  
  
  RESULTS
  Carotid IMT tended to significantly increase with NLR and age in men and with age in women. In men, multiple linear regression analyses adjusted for confounding factors showed that NLR (P < 0.001) and age (P = 0.001) had a significant positive association with carotid IMT (adjusted R(2) = 0.185, root mean squared error [MSE] = 0.152). However, no parameters showed significant positive associations in women.
  
  
  CONCLUSIONS
  NLR can be a clinically significant predictor of the degree of carotid stenosis in male patients with ischemic stroke. However, additional studies are required to obtain more concrete results.
authors: Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: Sangho
authors: S
authors: Hyun
authors: Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea. Electronic address: kkokkottung@hanmail.net.
authors: Seungwon
authors: S
authors: Kwon
authors: Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: SeungYeon
authors: S
authors: Cho
authors: Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: SeongUk
authors: S
authors: Park
authors: Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: WooSang
authors: W
authors: Jung
authors: Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: SangKwan
authors: S
authors: Moon
authors: Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: JungMi
authors: J
authors: Park
authors: Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: ChangNam
authors: C
authors: Ko
authors: Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.
authors: KiHo
authors: K
authors: Cho
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002545:Brain Ischemia / Q000150:complications; D059168:Carotid Intima-Media Thickness; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications* / Q000209:etiology; D014463:Ultrasonography
keywords: Atherosclerosis; Atherosclerosis predictor; Carotid artery stenosis; Ischemic stroke; Neutrophil-to-lymphocyte ratio