Generic placeholder image

Current Neurovascular Research

Editor-in-Chief

ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

Research Article

Predicting Futile Recanalization in Acute Ischemic Stroke Patients Undergoing Endovascular Thrombectomy: The Role of White Blood Cell Count to Mean Platelet Volume Ratio

Author(s): Wantong Yu, Milan Jia, Wenting Guo, Jiali Xu, Changhong Ren, Sijie li, Wenbo Zhao, Jian Chen, Jiangang Duan, Qingfeng Ma, Haiqing Song and Xunming Ji*

Volume 21, Issue 1, 2024

Published on: 21 December, 2023

Page: [6 - 14] Pages: 9

DOI: 10.2174/0115672026288143231212051101

Price: $65

Abstract

Background: Approximately half of AIS patients have an unfavorable outcome even after complete reperfusion. White blood cell (WBC) count to mean platelet volume (MPV) ratio (WMR) may be a promising predictive factor for futile recanalization. This study aimed to determine the predictive value of WMR in identifying individuals at higher risk of futile recanalization.

Methods: In this retrospective cohort study, 296 patients who achieved complete reperfusion after endovascular treatment (EVT) were included in the analysis. WBC count and MPV were collected at admission. Multivariable logistic regression was used to examine the independent association of the WMR with functional outcomes at three months. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) analyses were used to compare the accuracy of WMR for predicting futile recanalization.

Results: The adjusted odds ratios for the fourth quartile of WMR were 3.142 (95% CI 1.405- 7.027, P = 0.005) for unfavorable outcomes at 3 months in comparison with the first quartile. The inclusion of WMR in the traditional model enabled a more accurate prediction of unfavorable outcomes (NRI 0.250, P = 0.031; IDI 0.022, P = 0.017).

Conclusion: Elevated WMR at admission was independently associated with futile recanalization among AIS patients who received EVT and might be useful in identifying futile recanalization.

[1]
Goyal M, Menon BK, van Zwam WH, et al. Endovascular thrombectomy after large-vessel ischaemic stroke: A meta-analysis of individual patient data from five randomised trials. Lancet 2016; 387(10029): 1723-31.
[http://dx.doi.org/10.1016/S0140-6736(16)00163-X] [PMID: 26898852]
[2]
Leng T, Xiong ZG. Treatment for ischemic stroke: From thrombolysis to thrombectomy and remaining challenges. Brain Circ 2019; 5(1): 8-11.
[http://dx.doi.org/10.4103/bc.bc_36_18] [PMID: 31001594]
[3]
Deng G, Xiao J, Yu H, et al. Predictors of futile recanalization after endovascular treatment in acute ischemic stroke: A meta-analysis. J Neurointerv Surg 2022; 14(9): 881-5.
[http://dx.doi.org/10.1136/neurintsurg-2021-017963] [PMID: 34544824]
[4]
Hanna Ryder C, Gidron Y, Ryder D, et al. The relationship between immune and inflammatory markers and short-term clinical outcomes after stroke: Side matters. Isr Med Assoc J 2023; 25(4): 298-302.
[PMID: 37129131]
[5]
Chen PY, Chen GC, Hsiao CL, et al. Comparison of clinical features, immune-inflammatory markers, and outcomes between patients with acute in-hospital and out-of-hospital ischemic stroke. J Inflamm Res 2022; 15: 881-95.
[http://dx.doi.org/10.2147/JIR.S342830] [PMID: 35177921]
[6]
Guetl K, Raggam RB, Muster V, et al. The white blood cell count to mean platelet volume ratio for the prediction of chronic limb-threatening ischemia in lower extremity artery disease. J Clin Med 2019; 8(10): 1593.
[http://dx.doi.org/10.3390/jcm8101593] [PMID: 31581728]
[7]
Çiçek G, Açıkgöz SK, Yayla Ç, Kundi H, İleri M. White blood cell count to mean platelet volume ratio: A novel and promising prognostic marker for ST-segment elevation myocardial infarction. Cardiol J 2016; 23(3): 225-35.
[http://dx.doi.org/10.5603/CJ.a2016.0001] [PMID: 26779969]
[8]
Mohammed AA, Liu L, Mareai RM, et al. Combination of white blood cell count to mean platelet volume ratio and neutrophil-to-platelet ratio predicts long-term adverse events in patients with minoca. Mediators Inflamm 2022; 2022: 1-11.
[http://dx.doi.org/10.1155/2022/5642406] [PMID: 36016662]
[9]
Sivri S, Sökmen E, Celik M, Ozbek SC, Yildirim A, Boduroglu Y. Usefulness of white blood cell count to mean platelet volume ratio in the prediction of SYNTAX score in patients with non-ST elevation myocardial infarction. Pak J Med Sci 2019; 35(3): 824-9.
[http://dx.doi.org/10.12669/pjms.35.3.1017] [PMID: 31258602]
[10]
Weng Y, Gao Y, Zhao M, et al. The white blood cell count to mean platelet volume ratio for ischemic stroke patients after intravenous thrombolysis. Front Immunol 2022; 13: 995911.
[http://dx.doi.org/10.3389/fimmu.2022.995911] [PMID: 36263052]
[11]
Pan H, Lin C, Chen L, et al. Multiple-factor analyses of futile recanalization in acute ischemic stroke patients treated with mechanical thrombectomy. Front Neurol 2021; 12: 704088.
[http://dx.doi.org/10.3389/fneur.2021.704088] [PMID: 34489851]
[12]
Feng Y, Bai X, Li W, et al. Postoperative neutrophil-lymphocyte ratio predicts unfavorable outcome of acute ischemic stroke patients who achieve complete reperfusion after thrombectomy. Front Immunol 2022; 13: 963111.
[http://dx.doi.org/10.3389/fimmu.2022.963111] [PMID: 36275640]
[13]
Lassarén P, Lindblad C, Frostell A, et al. Systemic inflammation alters the neuroinflammatory response: A prospective clinical trial in traumatic brain injury. J Neuroinflammation 2021; 18(1): 221.
[http://dx.doi.org/10.1186/s12974-021-02264-2] [PMID: 34563211]
[14]
Simats A, Liesz A. Systemic inflammation after stroke: Implications for post-stroke comorbidities. EMBO Mol Med 2022; 14(9): e16269.
[http://dx.doi.org/10.15252/emmm.202216269] [PMID: 35971650]
[15]
Nording HM, Seizer P, Langer HF. Platelets in inflammation and atherogenesis. Front Immunol 2015; 6: 98.
[http://dx.doi.org/10.3389/fimmu.2015.00098] [PMID: 25798138]
[16]
Parker WAE, Storey RF. The role of platelet P2Y 12 receptors in inflammation. Br J Pharmacol 2023; bph. 16256.
[http://dx.doi.org/10.1111/bph.16256] [PMID: 37771103]
[17]
Peña-Garcia PE, Morales-Ortiz J, Marrero-Polanco J, Virgillio A, Finette BA, Washington AV, et al. Decreased level of trem like transcript 1 (tlt-1) is associated with prematurity and promotes the in-utero inflammatory response to maternal lipopolysaccharide (lps) exposure. Am J Reprod Immunol 2023; 90: e13772.
[18]
Su C, Lu Y, Wang Z, et al. Atherosclerosis: The involvement of immunity, cytokines and cells in pathogenesis, and potential novel therapeutics. Aging Dis 2023; 14(4): 1214-42.
[PMID: 37163428]
[19]
Li L, Han Z, Yang Z, et al. Circulating inflammatory biomarkers level before thrombolysis for acute ischemic stroke predicts symptomatic intracerebral hemorrhage. Aging Dis 2023; 14(1): 9-13.
[http://dx.doi.org/10.14336/AD.2022.0608] [PMID: 36818569]
[20]
Wu J, Wu Z, He A, et al. Genome-wide screen and validation of microglia pro-inflammatory mediators in stroke. Aging Dis 2021; 12(3): 786-800.
[http://dx.doi.org/10.14336/AD.2020.0926] [PMID: 34094642]
[21]
Dornbos D III, Ding Y. Reperfusion injury in the age of revascularization. Brain Circ 2018; 4(1): 40-2.
[http://dx.doi.org/10.4103/bc.BC_5_18] [PMID: 30276335]
[22]
Li J, Lin J, Pan Y, et al. Interleukin-6 and YKL-40 predicted recurrent stroke after ischemic stroke or TIA: Analysis of 6 inflammation biomarkers in a prospective cohort study. J Neuroinflammation 2022; 19(1): 131.
[http://dx.doi.org/10.1186/s12974-022-02467-1] [PMID: 35761288]
[23]
Cui L, Zhang Y, Chen Z, Su Y, Liu Y, Boltze J. Early neutrophil count relates to infarct size and fatal outcome after large hemispheric infarction. CNS Neurosci Ther 2020; 26(8): 829-36.
[http://dx.doi.org/10.1111/cns.13381] [PMID: 32374521]
[24]
Lux D, Alakbarzade V, Bridge L, et al. The association of neutrophil-lymphocyte ratio and lymphocyte-monocyte ratio with 3-month clinical outcome after mechanical thrombectomy following stroke. J Neuroinflammation 2020; 17(1): 60.
[http://dx.doi.org/10.1186/s12974-020-01739-y] [PMID: 32070366]
[25]
Xie J, Pang C, Yu H, Zhang W, Ren C, Deng B. Leukocyte indicators and variations predict worse outcomes after intravenous thrombolysis in patients with acute ischemic stroke. J Cereb Blood Flow Metab 2023; 43(3): 393-403.
[http://dx.doi.org/10.1177/0271678X221142694] [PMID: 36420778]
[26]
Chen Z, He Y, Su Y, Sun Y, Zhang Y, Chen H. Association of inflammatory and platelet volume markers with clinical outcome in patients with anterior circulation ischaemic stroke after endovascular thrombectomy. Neurol Res 2021; 43(6): 503-10.
[http://dx.doi.org/10.1080/01616412.2020.1870359] [PMID: 33402058]
[27]
Murphy JM, Jeong K, Tran DTK, et al. Nuclear FAK in endothelium: An intrinsic inhibitor of NF-κB activation in atherosclerosis. Atherosclerosis 2023; 379: 117189.
[http://dx.doi.org/10.1016/j.atherosclerosis.2023.117189] [PMID: 37527611]
[28]
Honig A, Molad J, Horev A, et al. Predictors and prognostic implications of hemorrhagic transformation following cerebral endovascular thrombectomy in acute ischemic stroke: A multicenter analysis. Cardiovasc Intervent Radiol 2022; 45(6): 826-33.
[http://dx.doi.org/10.1007/s00270-022-03115-0] [PMID: 35296934]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy