title: The relationship of platelet-to-lymphocyte ratio with clinical outcome and final infarct core in acute ischemic stroke patients who have undergone endovascular therapy.
abstract: OBJECTIVE
  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)].
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Nigde Bor State Hospital, Neurology Clinic , Nigde , Turkey.
authors.forename: Ozge
authors.initials: O
authors.lastname: Altintas
authors.affiliation: b Faculty of Engineering, Department of Genetics and Bioengineering , Fatih University , Istanbul , Turkey.
authors.forename: Mehmet Ozgen
authors.initials: MO
authors.lastname: Altintas
authors.affiliation: c Medicalpark Tarsus Hospital, Cardiology Clinic , Mersin , Turkey.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Tasal
authors.affiliation: d Bakirkoy Dr. Sadi Konuk Education and Training Hospital, Emergency Clinic , Istanbul , Turkey.
authors.forename: Okkes Taha
authors.initials: OT
authors.lastname: Kucukdagli
authors.affiliation: e Medical Faculty, Department of Neurology , Bezmi Alem Vakıf University , Istanbul , Turkey.
authors.forename: Talip
authors.initials: T
authors.lastname: Asil
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000473:pathology*; D020520:Brain Infarction / Q000209:etiology* / Q000473:pathology*; D002545:Brain Ischemia / Q000150:complications; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000209:etiology / Q000473:pathology / Q000601:surgery
keywords: Acute stroke; Endovascular treatment; Patient outcome; Platelet/lymphocyte ratio