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Che Y, Huang S, Zhou W, Shi S, Ye F, Ji Y, Huang J. Association between neutrophil-to-lymphocyte ratio and outcomes in hospitalized patients with left ventricular thrombus. Coron Artery Dis 2024; 35:397-404. [PMID: 38563191 PMCID: PMC11198952 DOI: 10.1097/mca.0000000000001363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 03/16/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Left ventricular thrombus (LVT) is a severe cardiovascular complication occurring in approximately 10% of patients with acute anterior ST-segment elevation myocardial infarction. This study aimed to evaluate the association between neutrophil-to-lymphocyte ratio (NLR) and in-hospital major adverse cardiovascular and cerebrovascular events (MACCE) in patients with LVT. MATERIAL AND METHODS This multicenter retrospective study was conducted between January 2000 and June 2022 in hospitalized patients with LVT. The outcome included in-hospital MACCE. The association between NLR and in-hospital MACCE was measured by odds ratios (ORs). The restricted cubic spline model was used for dose-response analysis. RESULTS A total of 197 LVT patients from four centers were included for analysis in this study. MACCE occurred in 13.7% (27/197) of the patients. After adjusting for estimated glomerular filtration rate (eGFR), D-dimer, and age, the OR for MACCE comparing first to the third tertile of NLR was 13.93 [95% confidence interval: 2.37-81.77, P = 0.004, P -trend = 0.008]. When further adjusting for etiology and heart failure with reduced ejection fraction (HFrEF), the association remained statistically significant. Spline regression models showed an increasing trend in the incidence of MACCEs with NLR both in crude and adjusted models. Subgroup analyses showed that a high NLR may be correlated with poorer outcomes for LVT patients older than 65 years, or with hypertension, dyslipidemia, low ejection fraction, liver, and renal dysfunctions. CONCLUSION In conclusion, these findings suggested that higher NLR may be associated with an increased risk of in-hospital MACCE in patients with LVT.
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Affiliation(s)
| | - Shenglan Huang
- Department of Cardiology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou
| | - Wei Zhou
- Department of Cardiology, Yixing People’s Hospital, Yixing
| | - Shunyi Shi
- Department of Cardiology, the Third Affiliated Hospital of Soochow University, Changzhou
| | - Fei Ye
- Department of Cardiology, Nanjing First Hospital, Nanjing
| | - Yuan Ji
- Department of Cardiology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou
| | - Jun Huang
- Department of Echocardiology, the Affiliated Changzhou No. 2 People’s Hospital of Nanjing Medical University, Changzhou, China
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Li Y, Xiang W, Xue H, Meng T, Zhang T, Zhang J, Wang J, Zhao J, Wang B. The impact of platelet indices on ischemic stroke: a Mendelian randomization study and mediation analysis. Front Neurol 2023; 14:1302008. [PMID: 38145119 PMCID: PMC10741650 DOI: 10.3389/fneur.2023.1302008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
Introduction Platelet indices (PIs) are hematological parameters that indicate the number, morphology, and activation of platelets. Although some clinical trials suggest an association between PIs and the risk of stroke, the lack of robust evidence is attributed to confounding effects and reverse causation. Objective This study aimed to evaluate the association between PIs and stroke risk through Mendelian randomization (MR) while exploring the mediating effect of blood pressure in this association. Methods We identified genetic variants associated with PIs, including platelet count (PLT), platelet distribution width (PDW), mean platelet volume (MPV), and platelet crit (PCT), in the UK Biobank (n = 350,474). Relevant genome-wide association studies were utilized to gather summary statistics pertaining to the traits of interest. We primarily used the inverse-variance weighted analysis to obtain estimates for individual causal power. Result We observed a positive correlation between genetically predicted increases in PCT levels with the stroke onset [PCT: OR (95%CI) = 1.113(1.047, 1.183), p < 0.001]. However, no significant causal relationship was found between PLT, PDW, and MPV and the risk of stroke [PLT: OR (95%CI) = 1.037(0.979, 1.098), p = 0.221; PDW: OR (95%CI) = 0.973(0.923, 1.024), p = 0.294; MPV: OR (95%CI) = 0.990(0.945, 1.038), p = 0.675]. Multivariable MR analyses and mediation analysis found that the proportion mediated by systolic blood pressure (SBP) is 23.71% [95%CI (10.85-33.31%)] and the proportion mediated by diastolic blood pressure (DBP) is 28.09% [95%CI (12.92-39.63%)]. Conclusion This large MR study presents evidence for the potential causal relationship between the PCT level and the risk of ischemic stroke, which might be mediated by blood pressure.
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Affiliation(s)
- Yang Li
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Wenping Xiang
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Hui Xue
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Tianyu Meng
- Graduate School, Chongqing Medical University, Chongqing, China
| | - Tianyou Zhang
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Jinfeng Zhang
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Jingbo Wang
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
| | - Jili Zhao
- Graduate School, Baotou Medical College, Baotou, Inner Mongolia, China
| | - Baojun Wang
- Department of Neurology, Inner Mongolia Institute of Cerebrovascular Diseases, Baotou Center Hospital, Baotou, Inner Mongolia, China
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Lang YS, Zhang YZ. Diagnostic values of leukocyte, neutrophil, and neutrophil to lymphocyte ratio in distinguishing central facial paralysis from peripheral facial paralysis. Clin Neurol Neurosurg 2023; 231:107832. [PMID: 37329734 DOI: 10.1016/j.clineuro.2023.107832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Revised: 05/23/2023] [Accepted: 06/04/2023] [Indexed: 06/19/2023]
Abstract
OBJECTIVE Misdiagnosis of central facial palsy (CFP) as peripheral facial palsy (PFP) can lead to serious consequences clinically. It is unknown whether the leukocyte counts (leukocyte), neutrophil counts (neutrophil), and neutrophil to lymphocyte ratio (NLR) can be used to distinguish CFP from PFP. METHODS Of the total 152 patients admitted for acute facial paralysis, 76 CFP patients (CFP group) caused by acute ischemic stroke (AIS) and 76 PFP cases (PFP group) without AIS were enrolled in this retrospective study. The levels of blood leukocyte, neutrophil, lymphocyte, platelet counts (platelet), NLR, and platelet to lymphocyte ratio (PLR) before or upon admission were recorded and compared between the two groups. The student t-test was adopted for comparison of the mean. Model discrimination was evaluated using the area under the receiver operating characteristic curve (AUC). Comparison of AUC was performed using the Z-test. RESULTS Compared with PFP group, the levels of leukocyte, neutrophil, and NLR were significantly increased in CFP group (all p < 0.01), and there were still significantly statistical differences (all p < 0.01), even after adjusting for age, gender, and past medical history, while no significantly statistical differences of lymphocyte, platelet, and PLR were found between CFP and PFP (all p > 0.05); furthermore, the AUC in distinguishing CFP from PFP were 0.629, 0.671, and 0.657 for leukocyte, neutrophil, and NLR, respectively, and no significant difference of AUC was observed among leukocyte, neutrophil, and NLR (p > 0.05); finally, the cutoff values (specificity, sensitivity, and Youden index) in distinguishing CFP from PFP were 7.08 × 109/L (65.79%, 57.89%, 0.237) for leukocyte, 4.90 × 109/L (73.68%, 60.53%, 0.342) for neutrophil, and 2.88 (72.37%, 55.26%, 0.276) for NLR, respectively. CONCLUSIONS As easy-to-obtain and inexpensive inflammatory biomarkers, leukocyte, neutrophil, and NLR could demonstrate diagnostic values in distinguishing between CFP and PFP.
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Affiliation(s)
- Ya-Song Lang
- Department of Emergency, Lianyungang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Lianyungang 222000, China
| | - Yue-Zhan Zhang
- Department of Geriatrics, Lianyungang TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Lianyungang 222000, China.
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Wang C, Jin W, Ma X, Dong Z. The different predictive value of mean platelet volume-to-lymphocyte ratio for postoperative recurrence between non-muscular invasive bladder cancer patients treated with intravesical chemotherapy and intravesical chemohyperthermia. Front Oncol 2023; 12:1101830. [PMID: 36713575 PMCID: PMC9874935 DOI: 10.3389/fonc.2022.1101830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/22/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction The inflammatory response plays a potential role in postoperative recurrence in patients with non-muscular invasive bladder cancer (NMIBC). We aimed to investigate whether platelet-to-lymphocyte ratio (PLR), mean platelet volume to lymphocyte ratio (MPVLR), and the systemic immune-inflammatory index (SII) have prognostic values in NMIBC treated with conventional intravesical chemotherapy or intravesical Chemohyperthermia (CHT) and the differences between them. Materials and methods A retrospective cohort study was conducted on 222 patients with NMIBC treated with Intravesical Chemotherapy or Intravesical CHT between January 2016 and December 2020. Within a week before surgery, PLR, MPVLR, and SII were determined based on routine blood settling. The optimal cutoff value of each index was determined using the receiver operating characteristic curve, and various groups were categorized accordingly. The factors influencing the prognosis of NMIBC patients receiving various treatments were investigated using the Kaplan- Meier survival curve and the Cox regression model. Results 69 cases (46.3%) in the gemcitabine (GEM) group had tumor recurrence and 19 (12.8%) of them progressed to muscle-invasive bladder cancer (MIBC) or got metastasis, while 19 cases (26.0%) in the CHT group recurred and 2 (2.7%) progressed. Elevated PLR, MPVLR, and SII were associated with higher recurrence rates in the GEM group. Meanwhile, PLR and MPVLR were the independent risk factors. While in the CHT group, high PLR and SII were related to postoperative recurrence and none of them were independent risk factors. Conclusion The preoperative clinical inflammatory indexes PLR, SII, and MPVLR have certain predictive value for the postoperative recurrence-free survival (RFS) in NMIBC patients treated with intravesical chemotherapy while PLR and SII can predict the prognosis of NMIBC patients treated with intravesical CHT, which indicates that intravesical CHT may stop tumor recurrence by influencing the effect of mean platelet volume on tumor growth through some unknown mechanisms.
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Affiliation(s)
- Chengbo Wang
- The Department of Urology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu, China
| | - Wenjun Jin
- The Department of Urology, Wuwei Cancer Hospital of Gansu Province, Wuwei, Gansu, China
| | - Xiaodong Ma
- The Department of Urology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu, China
| | - Zhilong Dong
- The Department of Urology, Lanzhou University Second Hospital, Lanzhou University, Lanzhou, Gansu, China,*Correspondence: Zhilong Dong,
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Song Y, Tian J, Yang L, Zhang Y, Dong Z, Ding H, Wang J, Wang Y, Wang H, Wang Z. Prognostic value of preoperative platelet-related parameters and plasma fibrinogen in patients with non-muscle invasive bladder cancer after transurethral resection of bladder tumor. Future Oncol 2022; 18:2933-2942. [PMID: 35880441 DOI: 10.2217/fon-2022-0223] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
Aim: To investigate the prognostic value of preoperative mean platelet volume (MPV), MPV/lymphocyte ratio (MPVLR), MPV/platelet count ratio and plasma fibrinogen in patients with non-muscle invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBT). Methods: A total of 371 patients who underwent TURBT were enrolled. The main end points were disease-free survival (DFS) and overall survival (OS). Results: MPVLR, tumor size, tumor number and pathological grade were independent risk factors for postoperative DFS. Age and pathological grade were independent risk factors for postoperative OS. Conclusion: MPVLR is an independent risk factor for DFS in NMIBC patients and could be used as a parameter to predict postoperative tumor recurrence in patients after TURBT.
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Affiliation(s)
- Yutong Song
- Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Gansu Province for Urological Diseases, Clinical Center of Gansu Province for Nephro-urology, Lanzhou University, Lanzhou, China
| | - Junqiang Tian
- Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Gansu Province for Urological Diseases, Clinical Center of Gansu Province for Nephro-urology, Lanzhou University, Lanzhou, China
| | - Li Yang
- Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Gansu Province for Urological Diseases, Clinical Center of Gansu Province for Nephro-urology, Lanzhou University, Lanzhou, China
| | - Yunxin Zhang
- Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Gansu Province for Urological Diseases, Clinical Center of Gansu Province for Nephro-urology, Lanzhou University, Lanzhou, China
| | - Zhilong Dong
- Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Gansu Province for Urological Diseases, Clinical Center of Gansu Province for Nephro-urology, Lanzhou University, Lanzhou, China
| | - Hui Ding
- Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Gansu Province for Urological Diseases, Clinical Center of Gansu Province for Nephro-urology, Lanzhou University, Lanzhou, China
| | - Juan Wang
- Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Gansu Province for Urological Diseases, Clinical Center of Gansu Province for Nephro-urology, Lanzhou University, Lanzhou, China
| | - Yuhan Wang
- Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Gansu Province for Urological Diseases, Clinical Center of Gansu Province for Nephro-urology, Lanzhou University, Lanzhou, China
| | - Hanzhang Wang
- Department of Urology, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA
| | - Zhiping Wang
- Institute of Urology, Lanzhou University Second Hospital, Key Laboratory of Gansu Province for Urological Diseases, Clinical Center of Gansu Province for Nephro-urology, Lanzhou University, Lanzhou, China
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Zheng YY, Wang L, Shi Q. Mean platelet volume (MPV) and platelet distribution width (PDW) predict clinical outcome of acute ischemic stroke: A systematic review and meta-analysis. J Clin Neurosci 2022; 101:221-227. [DOI: 10.1016/j.jocn.2022.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/05/2022] [Accepted: 05/23/2022] [Indexed: 11/15/2022]
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Xue W, Li Y, Xia H, Yu T, Sun S, Zhang M. Influence of neutrophil-to-lymphocyte ratio and mean platelet volume on severity and short-term prognosis of acute ischemic stroke. Am J Transl Res 2022; 14:4066-4073. [PMID: 35836843 PMCID: PMC9274605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/07/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE To investigate the influence of neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV) on the severity and short-term prognosis of acute ischemic stroke (AIS). METHODS A retrospective analysis was made on 188 AIS patients treated in our hospital from June 2019 to June 2021. They were divided into mild stroke group and severe stroke group based on NIHSS score. In view of the modified Rankin score (mRS) on 14th day after stroke, patients were divided into good prognosis group and bad prognosis group. The clinical data, NLR and MPV data of each group were compared, and the independent risk factors of short-term poor prognosis of AIS patients were analyzed by multivariate Logistic regression. RESULTS NLR and MPV in patients with mild stroke were lower than those with severe stroke (P<0.05). In addition, NLR and MPV of patients with good prognosis were lower than those with poor prognosis (P<0.05). Regression analysis revealed that high NLR and MPV were independent predictors of short-term poor prognosis of AIS patients. The AUC of NLR in predicting the poor prognosis of patients after 14 days of stroke was 0.904, and the specificity and sensitivity were 70.55% and 97.62%. A. AUC of MPV was 0.904, and the specificity and sensitivity were 92.47% and 85.71%. B. Pearson correlation analysis revealed that NLR was positively correlated with MPV (r=0.452, P<0.001). CONCLUSION The elevation of NLR and MPV may be independent risk factors of AIS, but it is related to the severity of stroke and short-term prognosis.
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Affiliation(s)
- Weimin Xue
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan No. 203, Huaibin Road, Tianjia'an District, Huainan 232007, Anhui Province, China
| | - Yaqiang Li
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan No. 203, Huaibin Road, Tianjia'an District, Huainan 232007, Anhui Province, China
| | - Henglei Xia
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan No. 203, Huaibin Road, Tianjia'an District, Huainan 232007, Anhui Province, China
| | - Tingting Yu
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan No. 203, Huaibin Road, Tianjia'an District, Huainan 232007, Anhui Province, China
| | - Shiyu Sun
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan No. 203, Huaibin Road, Tianjia'an District, Huainan 232007, Anhui Province, China
| | - Mei Zhang
- Department of Neurology, First Affiliated Hospital of Anhui University of Science and Technology, First People's Hospital of Huainan No. 203, Huaibin Road, Tianjia'an District, Huainan 232007, Anhui Province, China
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Mean Platelet Volume to Platelet Count Ratio as a Predictor of Mortality in Unstable Pertrochanteric Fracture Treated with Short Proximal Femoral Anterograde Nail. Indian J Orthop 2022; 56:1181-1191. [PMID: 35813541 PMCID: PMC9232663 DOI: 10.1007/s43465-022-00613-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Accepted: 02/13/2022] [Indexed: 02/04/2023]
Abstract
Introduction The relationship between mean platelet volume (MPV) and platelet count (PC, MPV/PC) has been studied in detail in various diseases. The aim of this study was to investigate the effect of the MPV/PC ratio in estimating the risk of postoperative mortality in unstable pertrochanteric fractures. In addition, serum biomarkers such as the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) will be compared with the MPV/PC ratio in predicting mortality. Materials and Methods We retrospectively reviewed the records of eligible adult patients with a pertrochanteric fracture who admitted to the Department of Orthopedics and Traumatology between January 2011 and December 2019. The MPV/PC ratio was estimated as the MPV value divided by the PC at admission, postoperative day 2, and postoperative day 5 of the surgery. The clinical outcome was 30-day mortality and overall mortality. Results We included 447 patients who received unstable pertrochanteric fracture surgery. In multivariate Cox proportional hazard models, higher MPV/PC ratios on admission were significant risk factors for 30-day mortality. In the ROC analysis, MPV/platelet ratio ≥ 0.048 at admission was critical for 30-day mortality (sensitivity 0.636, specificity 0.659, p < 0.001). Discussion The MPV/PC ratio alone predicted 30-day mortality in patients with pertrochanteric fracture. Further prospective and multicenter clinical trials supporting our findings and aiming to uncover the reason for the change in blood parameters will help to reduce mortality in unstable pertrochanteric fractures. Graphical abstract
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Ding B, Liu P, Zhang F, Hui J, He L. Predicting Values of Neutrophil-to-Lymphocyte Ratio (NLR), High-Sensitivity C-Reactive Protein (hs-CRP), and Left Atrial Diameter (LAD) in Patients with Nonvalvular Atrial Fibrillation Recurrence After Radiofrequency Ablation. MEDICAL SCIENCE MONITOR : INTERNATIONAL MEDICAL JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2022; 28:e934569. [PMID: 35082255 PMCID: PMC8805343 DOI: 10.12659/msm.934569] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The purpose of this study was to evaluate the predictive values of lipid level, inflammatory biomarkers, and echocardiographic parameters in late NVAF (nonvalvular atrial fibrillation) recurrence after RFA (radiofrequency ablation). MATERIAL AND METHODS This retrospective single-center study enrolled 263 patients with paroxysmal or persistent NVAF who underwent initial RFA from Jan 2017 to Jan 2019. The patients were divided into a Recurrent group (n=70) and a Nonrecurrent group (n=193). Univariate and multivariate logistic regression analyses were used for evaluating the predictive factors of late NVAF recurrence. Receiver operating characteristic (ROC) curves were constructed to assess the predictive performance and the optimum cut-off level of variables. RESULTS Late NVAF recurrence occurred in 70 patients (26.6%) after initial RFA within 12-month follow-up. Patients in the Recurrent group had significant higher NLR (neutrophil-to-lymphocyte ratio), hs-CRP (high-sensitivity C-reactive protein), LVEDD (left ventricular end-diastolic dimension), LVESD (left ventricular end-systolic dimension), and LAD (left atrial diameter) than those in the Nonrecurrent group (P<0.05). In multivariate analysis, increased NLR (HR=1.438, 95% CI: 1.036-1.995, P<0.05), hs-CRP (HR=1.137, 95% CI: 1.029-1.257, P<0.05) and LAD (HR=1.089, 95% CI: 1.036-1.146, P<0.05) were independent predictors of NVAF recurrence. The area under the curve (AUC) of NLR and hs-CRP was 0.603 (95% CI 0.525-0.681) and 0.584 (95% CI 0.501-0.666), respectively. The combination of NLR, hs-CRP, and LAD revealed an AUC of 0.684 (95% CI 0.611-0.757), with cut-off values of 2.33, 2.025 ng/L, and 44.5 mm, respectively. CONCLUSIONS The combination of preoperative NLR, hs-CRP, and LAD can predict late NVAF recurrence.
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Affiliation(s)
- Bing Ding
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Pengfei Liu
- Department of Cardiology, The First People's Hospital of Kunshan, Suzhou, Jiangsu, China (mainland)
| | - Fangfang Zhang
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Jie Hui
- Department of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
| | - Linyan He
- Jiangsu Institute of Hematology, National Clinical Research Center for Hematologic Diseases, NHC Key Laboratory of Thrombosis and Hemostasis, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (mainland)
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Alanazi EM, Abdou A, Luo J. Predicting Risk of Stroke From Lab Tests Using Machine Learning Algorithms: Development and Evaluation of Prediction Models. JMIR Form Res 2021; 5:e23440. [PMID: 34860663 PMCID: PMC8686476 DOI: 10.2196/23440] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/14/2020] [Accepted: 10/15/2021] [Indexed: 12/22/2022] Open
Abstract
Background Stroke, a cerebrovascular disease, is one of the major causes of death. It causes significant health and financial burdens for both patients and health care systems. One of the important risk factors for stroke is health-related behavior, which is becoming an increasingly important focus of prevention. Many machine learning models have been built to predict the risk of stroke or to automatically diagnose stroke, using predictors such as lifestyle factors or radiological imaging. However, there have been no models built using data from lab tests. Objective The aim of this study was to apply computational methods using machine learning techniques to predict stroke from lab test data. Methods We used the National Health and Nutrition Examination Survey data sets with three different data selection methods (ie, without data resampling, with data imputation, and with data resampling) to develop predictive models. We used four machine learning classifiers and six performance measures to evaluate the performance of the models. Results We found that accurate and sensitive machine learning models can be created to predict stroke from lab test data. Our results show that the data resampling approach performed the best compared to the other two data selection techniques. Prediction with the random forest algorithm, which was the best algorithm tested, achieved an accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under the curve of 0.96, 0.97, 0.96, 0.75, 0.99, and 0.97, respectively, when all of the attributes were used. Conclusions The predictive model, built using data from lab tests, was easy to use and had high accuracy. In future studies, we aim to use data that reflect different types of stroke and to explore the data to build a prediction model for each type.
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Affiliation(s)
- Eman M Alanazi
- Department of Health Informatics, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia.,Department of Biomedical and Health Informatics, College of Engineering, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Aalaa Abdou
- Department of Radiotherapy, Children's Cancer Hospital 57357, Cairo, Egypt
| | - Jake Luo
- Department of Health Informatics and Administration, College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
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Neutrophil to lymphocyte ratio and fibrinogen values in predicting patients with type B aortic dissection. Sci Rep 2021; 11:11366. [PMID: 34059762 PMCID: PMC8166888 DOI: 10.1038/s41598-021-90811-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 05/13/2021] [Indexed: 11/24/2022] Open
Abstract
The aim of this study is to detect the diagnosis value of neutrophil lymphocyte ratio (NLR) and fibrinogen (FIB) in type B aortic dissection (TBAD) patients. This retrospective observation study consisted patients with TBAD, aortic aneurysm and physical examination between January 1, 2016 and December 31, 2019. Demographic and clinical information after the first admission were collected. Multivariate logistic regression analysis was performed to explore the correlational relationship between NLR, FIB and TBAD. Receiver Operating Characteristic Curve (ROC) was performed to evaluate the diagnostic implication of NLR and FIB in TBAD patients. Six hundred and six patients who were first diagnosed with TBAD were included. Control groups were 202 aortic aneurysm and 140 physical examination subjects. The level of NLR and FIB in aortic dissection patients was significantly higher than aortic aneurysm patients and healthy group (P < 0.001). According to the results of multivariate logistic regression analysis, NLR and FIB were independent risk factors of aortic dissection, and the odds ratio (OR) and 95% confidence interval (CI) value of NLR and FIB were 1.499 (1.126–1.738) and 1.914 (1.475–2.485), respectively. The area under the curve (AUC) was 0.836 of NLR and 0.756 of FIB. NLR and FIB showed high specificity, 89% and 83% respectively. This is the first study provided information on the diagnosis performance of NLR and FIB in TBAD patients. NLR and FIB showed high specificity, which may be a valuable tool for the diagnosis of TBAD.
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Llorente-Chávez A, Martín-Nares E, Núñez-Álvarez C, Hernández-Molina G. Thrombosis and thrombocytopenia in antiphospholipid syndrome: their association with mean platelet volume and hematological ratios. Thromb Res 2021; 203:12-17. [PMID: 33895567 DOI: 10.1016/j.thromres.2021.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/11/2021] [Accepted: 04/12/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To assess the mean platelet volume (MPV), platelet-to-lymphocyte ratio (PLR), the neutrophil-to-lymphocyte ratio (NLR) and the MPV-to-lymphocyte ratio, and to test them according to the clinical/serological status, shift through time and other comorbidities in APS. METHODS We included 96 primary APS patients according to the Sydney classification criteria and/or patients with thrombocytopenia and/or autoimmune hemolytic anemia who also fulfilled the serological criteria. We tested aCL, anti-β2GP-I and aPS/PT antibodies and LA. We first registered the MPV and the aforementioned ratios within at least 6 months after an event of thrombosis or thrombocytopenia/AIHA (baseline determination), and during thrombosis/thrombocytopenia/AIHA onset when available (acute event). RESULTS A lower baseline MPV and a higher PLR characterized the thrombotic group (n = 74). The AUC for baseline PLR was 0.82 (p < 0.001): SE of 69%, SP 91%, PPV 96%, NPV 74%, LR+ 13.67 and LR- 0.19. During the acute event, both variables increased. The thrombocytopenic group (n = 66) had a higher baseline MPV and a lower PLR, and during an acute event the PLR decreased more deeply. The AUC for MPV was 0.64 (p = 0.02): SE 44%, SP 92%, PPV 86%, NPV 40%, LR+ 3.3 and LR- 0.85. These findings were not related with the aPL antibody profile status, titers or comorbidities. CONCLUSION Basal MPV and PLR might help to identify APS patients according to their thrombotic or thrombocytopenic phenotype. These variables change during the acute events and might be the reflex of physiopathological or compensatory mechanisms in APS.
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Affiliation(s)
- Amaya Llorente-Chávez
- Internal Medicine Service, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, CP 14080 Ciudad de México, Mexico
| | - Eduardo Martín-Nares
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, CP 14080 Ciudad de México, Mexico
| | - Carlos Núñez-Álvarez
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, CP 14080 Ciudad de México, Mexico
| | - Gabriela Hernández-Molina
- Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Colonia Belisario Domínguez Sección XVI, CP 14080 Ciudad de México, Mexico.
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13
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Han Y, Li G, Tang Y, Zhang B, Zhan Y, Zhang C, Zuo L, Wu W. Effect of rt-PA intravenous thrombolysis on the prognosis of patients with minor ischemic stroke. Neurol Res 2021; 43:653-658. [PMID: 33847231 DOI: 10.1080/01616412.2021.1908672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIMS The evidence of rt-PA intravenous thrombolysis in patients with minor ischemic stroke (MIS) is still controversial. This study aims to investigate the effect of rt-PA intravenous thrombolysis on the prognosis of patients with MIS. METHODS We continuously enrolled and analyzed patients with MIS admitted into our hospital within 24 h after symptom onset between January 2016 and December 2018, including 96 patients received intravenous thrombolysis within 4.5 h after symptom onset and 84 patients not received intravenous thrombolysis. A favorable long-term outcome was a 90-day mRS score of 0-1. Good short-term outcome was a 7-day NIHSS score of 0 or less than NIHSS onset. RESULTS There were no statistical differences between two groups of patients' age, gender, history of hypertension, coronary heart disease, atrial fibrillation, smoking, drinking, and baseline NIHSS score. Patients with history of stroke (22.62% vs. 10.42%, p < 0.05) and diabetes (46.43% vs. 22.92%, p = 0.01) were higher in group of non-thrombolysis. The difference of NIHSS score after 7 days was statistically different between the two groups (p < 0.05), while there was no significant difference in 90-day mRS score. Logistic regression analysis indicated that the prognosis of patients was correlated with neutrophil ratio and CRP at admission. CONCLUSION Patients with MIS received intravenous thrombolysis may be associated with earlier neurological improvement, but might has no significant effect on long-term prognosis. The level of neutrophil ratio and CRP at admission are risk factors determining the prognosis, which requires further research.
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Affiliation(s)
- Yingying Han
- Department of Neurology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Gang Li
- Department of Neurology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yueyu Tang
- Department of Neurology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Bei Zhang
- Department of Neurology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yiqiang Zhan
- Department of Neurology, Yang-Si Hospital, Shanghai, China
| | - Chunfang Zhang
- Department of Shanghai Pudong Medical Emergency Center, Shanghai, China
| | - Lian Zuo
- Department of Neurology, East Hospital, Tongji University School of Medicine, Shanghai, China
| | - Wei Wu
- Department of Neurology, Qi-Lu Hospital of Shandong University and Brain Science Research Institute, Shandong University, Shandong, China
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14
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Huang LY, Sun FR, Yin JJ, Ma YH, Li HQ, Zhong XL, Yu JT, Song JH, Tan L. Associations of the neutrophil to lymphocyte ratio with intracranial artery stenosis and ischemic stroke. BMC Neurol 2021; 21:56. [PMID: 33546646 PMCID: PMC7863476 DOI: 10.1186/s12883-021-02073-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/24/2021] [Indexed: 12/17/2022] Open
Abstract
Background The neutrophil-to-lymphocyte ratio (NLR) has emerged as an inflammatory marker. However, the associations of NLR with intracranial artery stenosis (ICAS) and ischemic stroke remain unclear. This study aimed to examine the associations of NLR with ICAS and ischemic stroke among a large and high-risk population. Methods Participants with records of clinical characteristics were prospectively recruited from the Neurology Department and Health & Physical Examination Center of Qingdao Municipal Hospital. Logistic regression analysis was used to examine the associations of NLR with ICAS and ischemic stroke. Moreover, we also conducted parametric mediation analysis to estimate the effect of NLR on the risk of ischemic stroke mediated through ICAS. Results A total of 2989 participants were enrolled in this study. After adjusting for covariates, NLR (OR = 1.125, 95%CI 1.070–1.183) and ICAS (OR = 1.638, 95%CI 1.364–1.967) were significantly associated with ischemic stroke. Compared with the first quartile NLR, the second, third and fourth quartiles NLR were independent risk predictors for ischemic stroke (P for trend < 0.001); the third and fourth quartiles were independent predictors for ICAS (P for trend < 0.001). The mediation analysis showed that ICAS partially mediated the association between NLR and ischemic stroke, accounting for 14.4% of the total effect (P < 0.001). Conclusions NLR was significantly associated with ICAS and ischemic stroke. Besides, ICAS partially mediated the association between NLR and ischemic stroke.
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Affiliation(s)
- Liang-Yu Huang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266071, China
| | - Fu-Rong Sun
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266071, China
| | - Jian-Jun Yin
- Department of Neurology, Qingdao Hiser Hospital, Qingdao University, Qingdao, China
| | - Ya-Hui Ma
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266071, China
| | - Hong-Qi Li
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, 12th Wulumuqi Zhong Road, Shanghai, 200040, China
| | - Xiao-Ling Zhong
- Department of Neurology, Qingdao Central Hospital, Qingdao University, Qingdao, China
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, 12th Wulumuqi Zhong Road, Shanghai, 200040, China.
| | - Jing-Hui Song
- Department of Neurology, The Affiliated Hospital of Qingdao University, Qingdao, China.
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, 266071, China.
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15
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Deng QW, Gong PY, Chen XL, Liu YK, Jiang T, Zhou F, Hou JK, Lu M, Zhao HD, Zhang YQ, Wang W, Shen R, Li S, Sun HL, Chen NH, Shi HC. Admission blood cell counts are predictive of stroke-associated infection in acute ischemic stroke patients treated with endovascular therapy. Neurol Sci 2020; 42:2397-2409. [PMID: 33057978 DOI: 10.1007/s10072-020-04827-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/12/2020] [Indexed: 12/20/2022]
Abstract
Stroke-associated infection (SAI) is a major medical complication in acute ischemic stroke patients (AIS) treated with endovascular therapy (EVT). Three hundred thirty-three consecutive patients with AIS caused by a large vessel occlusion in the anterior circulation who received EVT (142 (42.6%) of them were given IV tPA as bridging therapy) and 337 AIS patients who received IV tPA only (non-EVT) were enrolled in the study and evaluated to determine the association of inflammatory factors on admission with SAI. Among the 333 AIS patients undergoing EVT, SAI occurred in 219 (65.8%) patients. Patients with SAI had higher baseline National Institutes of Health Stroke Scale (NIHSS) total scores, white blood cell (WBC) and neutrophil counts, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) than those without SAI (P < 0.05). The multivariable logistic regression analyses showed that older age in addition to higher diastolic blood pressure (DBP), NIHSS score, fasting blood glucose, WBC and neutrophil counts, NLR, and PLR were significantly associated with SAI (P < 0.05). However, these associations were not revealed in 337 non-EVT AIS patients. Furthermore, based on the inflammatory markers, we developed a nomogram that provided the opportunity for more accurate predictions (compared with conventional factors) and appeared a better prognostic tool for SAI according to the decision curve analysis. In summary, if proven externally valid, our nomogram that included WBC count, NLR, and PLR may be a useful tool for SAI prediction in clinical practice.
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Affiliation(s)
- Qi-Wen Deng
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Peng-Yu Gong
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Xiang-Liang Chen
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Yu-Kai Liu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Teng Jiang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Feng Zhou
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Jian-Kang Hou
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Min Lu
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Hong-Dong Zhao
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Yu-Qiao Zhang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Wei Wang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Rui Shen
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China
| | - Shuo Li
- Department of Neurology, Affiliated ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, 210009, China
| | - Hui-Ling Sun
- General Clinical Research Center, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
| | - Ni-Hong Chen
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China. .,Department of Neurology, Nanjing Yuhua Hospital, Yuhua Branch of Nanjing First Hospital, Nanjing Medical University, Nanjing, 210039, China.
| | - Hong-Chao Shi
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
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16
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Wijeratne T, Menon R, Sales C, Karimi L, Crewther S. Carotid artery stenosis and inflammatory biomarkers: the role of inflammation-induced immunological responses affecting the vascular systems. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1276. [PMID: 33178808 PMCID: PMC7607082 DOI: 10.21037/atm-20-4388] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The death, disability and economic cost of stroke are enormous. Indeed, among the 16 million people worldwide who suffer a stroke' annually, nearly six million die, and another five million are left permanently disabled making prevention of stroke one of the most important priorities in healthcare. Currently carotid artery stenosis (CS) or narrowing of the common carotid artery (CCA) or internal carotid artery (ICA) due to atherosclerotic plaque, accounts for 20-30% of all ischemic strokes. Atherosclerosis is now regarded as a chronic inflammatory disease in response to vascular compromise especially from hypertension. This has long been known to lead to inflammation and atherosclerotic plaque formation in the blood vessels. This mini-review aims to highlight the role of inflammation and neuro-immunological processes in carotid artery disease. Various cellular elements of inflammation and advanced imaging techniques have been identified as potential markers of plaque progression. Therapies related to decreasing and modulating immune-responsive inflammation in the carotid vessels have been shown to translate into decreased occurrence of acute neurologic events and improvement of clinical outcomes.
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Affiliation(s)
- Tissa Wijeratne
- Department of Neurology, AIMSS, WHCRE level three, Sunshine Hospital and Melbourne Medical School, St Albans, Victoria, Australia.,School of Public health and Psychology, La Trobe University, Bundoora, Victoria, Australia.,Department of Medicine, Faculty of Medicine, Rajarata University, Saliyapura, Anuradhapura, Sri Lanka
| | - Rohit Menon
- Department of Neurology and Stroke Service, Western Health, AIMSS, level 3, WHCRE, Sunshine Hospital, St Albans, Victoria, Australia
| | - Carmela Sales
- Department of Neurology and Stroke Service, Western Health, AIMSS, level 3, WHCRE, Sunshine Hospital, St Albans, Victoria, Australia
| | - Leila Karimi
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
| | - Sheila Crewther
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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17
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Abstract
Patients with stroke have a high risk of infection which may be predicted by age, procalcitonin, interleukin-6, C-reactive protein, National Institute of Health stroke scale (NHSS) score, diabetes, etc. These prediction methods can reduce unfavourable outcome by preventing the occurrence of infection.We aim to identify early predictors for urinary tract infection in patients after stroke.In 186 collected acute stroke patients, we divided them into urinary tract infection group, other infection type groups, and non-infected group. Data were recorded at admission. Independent risk factors and infection prediction model were determined using Logistic regression analyses. Likelihood ratio test was used to detect the prediction effect of the model. Receiver operating characteristic curve and the corresponding area under the curve were used to measure the predictive accuracy of indicators for urinary tract infection.Of the 186 subjects, there were 35 cases of urinary tract infection. Elevated interleukin-6, higher NIHSS, and decreased hemoglobin may be used to predict urinary tract infection. And the predictive model for urinary tract infection (including sex, NIHSS, interleukin-6, and hemoglobin) have the best predictive effect.This study is the first to discover that decreased hemoglobin at admission may predict urinary tract infection. The prediction model shows the best accuracy.
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Affiliation(s)
- Ya-ming Li
- Department of Neurology, Jiading District Central Hospital affiliated to Shanghai University of Medicine & Health Sciences
| | - Jian-hua Xu
- Department of Neurology, Jiading District Central Hospital affiliated to Shanghai University of Medicine & Health Sciences
| | - Yan-xin Zhao
- Department of Neurology, Tenth People's Hospital affiliated to Tongji University, Shanghai, China
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18
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Breheny CR, Handel I, Banner S, Milne EM, Morrison LR, Smith SH, Kilpatrick S, Gow A, Mellanby RJ. Neutrophilia is associated with a poorer clinical outcome in dogs with chronic hepatitis. Vet Rec 2020; 187:234. [PMID: 31974266 DOI: 10.1136/vr.105533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 10/17/2019] [Accepted: 12/16/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Liver disease is a common cause of morbidity and mortality in dogs. Currently, it is challenging to prognosticate in these cases. The aim of this study was to evaluate the utility of the haematological variables in dogs with chronic hepatitis. METHODS Dogs with chronic hepatitis confirmed on histopathology had presenting haematological values retrospectively obtained and evaluated against survival time. Eighty-two dogs met the inclusion criteria and their data analysed. RESULTS Neutrophilic patients, with a count greater than 12×109/l, controlled for sex and age, had a shorter survival time (P≤0.01). In dogs, neutrophilia at presentation predicted a poor outcome, whereas the other haematological parameters were not prognostically informative. When the dogs were split into even quarters on the basis of their neutrophil count, those within the higher quartiles had poorer survival times. Neutrophilia was associated with a poorer survival time in comparison to those patients with a lower count. CONCLUSION The relationship between neutrophils, inflammation and clinical outcome is deserving of future study in dogs with chronic hepatitis.
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Affiliation(s)
- Craig R Breheny
- Hospital for Small Animals, University of Edinburgh Royal Dick School of Veterinary Studies, Easter Bush, UK
| | - Ian Handel
- Centre for Infectious Diseases, University of Edinburgh, Edinburgh, UK
| | | | - Elspeth M Milne
- Veterinary Pathology Unit, University of Edinburgh, Edinburgh, UK
| | - Linda R Morrison
- Veterinary Pathology Unit, University of Edinburgh, Edinburgh, UK
| | - Sionagh H Smith
- Veterinary Pathology Unit, University of Edinburgh, Edinburgh, UK
| | - Scott Kilpatrick
- Hospital for Small Animals, University of Edinburgh Royal Dick School of Veterinary Studies, Easter Bush, UK
| | - Adam Gow
- Hospital for Small Animals, University of Edinburgh Royal Dick School of Veterinary Studies, Easter Bush, UK
| | - Richard J Mellanby
- Hospital for Small Animals, University of Edinburgh Royal Dick School of Veterinary Studies, Easter Bush, UK
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19
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Liu L, Zhao Y, Cui J, Chen S, Shi B. Evaluation of platelet distribution width as a diagnostic and prognostic biomarker in bladder neoplasm. Future Oncol 2019; 15:3797-3807. [PMID: 31532234 DOI: 10.2217/fon-2019-0441] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aim: To evaluate the role of preoperative platelet distribution width (PDW) as a potential biomarker for distinguishing malignancy and tumor advantage of bladder neoplasm. Methods: The study included 210 subjects with bladder cancer, 76 subjects with urothelial papilloma and 132 healthy control subjects. Preoperative PDW along with other blood indices was evaluated. Results: PDW was higher in urothelial papilloma patients than that in bladder cancer patients (p < 0.001). Bladder cancer patients with advanced-stage disease exhibited lower PDW levels compared with patients with early stage disease. Conclusion: Reduced preoperative PDW level is an indicator of malignancy and advanced bladder cancer stages, suggesting it as a potential biomarker in bladder cancer diagnosis and prognosis.
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Affiliation(s)
- Lei Liu
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Yajing Zhao
- Department of Hematology, Qilu Hospital of Shandong University, Jinan, China
| | - Jianfeng Cui
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Shouzhen Chen
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
| | - Benkang Shi
- Department of Urology, Qilu Hospital of Shandong University, Jinan, China
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20
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Sadeghi F, Kovács S, Zsóri KS, Csiki Z, Bereczky Z, Shemirani AH. Platelet count and mean volume in acute stroke: a systematic review and meta-analysis. Platelets 2019; 31:731-739. [PMID: 31657263 DOI: 10.1080/09537104.2019.1680826] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Changes of mean platelet volume (MPV) and platelet count (PC) could be a marker or a predictor of acute stroke (AS). We conducted a systematic review and meta-analysis of the published literature on the reporting of MPV and PC in AS. Studies were included in accordance with Patient Population or Problem, Intervention, Comparison, Outcomes, and Setting framework. The PRISMA strategy was used to report findings. Risk of bias was assessed with the Newcastle-Ottawa Scale. We included 34 eligible articles retrieved from the literature. PC was significantly lower in AS patients [standardized mean difference (SMD) = - 0.30, (95% CI: - 0.49 to - 0.11), N = 2492, P = .002] compared with controls (N = 3615). The MPV was significantly higher [SMD = 0.52 (95% CI: 0.28-0.76), N = 2739, P < .001] compared with controls (N = 3810). Subgroup analyses showed significantly lower PC in both ischemic stroke (Difference SMD = -0.18, 95% CI: -0.35-0.01) and hemorrhagic stroke (-0.94, -1.62 to -0.25), but only samples by citrate anticoagulant showed significantly lower result for patients compared to controls (-0.36, -0.68 to -0.04). Ischemic stroke patients had higher MPV (0.57, 0.31-0.83), and samples by Ethylenediaminetetraacetic acid (EDTA) anticoagulant showed significantly higher result for patients compared to controls (0.86, 0.55-1.17). PC and MPV appeared to be significantly different between patients with AS and control populations. MPV was significantly higher in ischemic stroke and PC was significantly lower in both ischemic and hemorrhagic strokes. These characteristics might be related to AS and associated with it. It is advisable to pay attention to elapsed time between phlebotomy and hematology analysis, anticoagulant and hemocytometer types in AS. SYSTEMATIC REVIEW REGISTRATION This meta-analysis is registered on the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42017067864 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=67864).
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Affiliation(s)
- Farzaneh Sadeghi
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen , Debrecen, Hungary
| | - Sándor Kovács
- Department of Research Methodology and Statistics, Institute of Sectorial Economics and Methodology, Faculty of Economics and Business, Debrecen University , Debrecen, Hungary
| | | | - Zoltán Csiki
- Department of Medicine, Debrecen University , Debrecen, Hungary
| | - Zsuzsanna Bereczky
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen , Debrecen, Hungary
| | - Amir Houshang Shemirani
- Division of Clinical Laboratory Science, Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen , Debrecen, Hungary.,Central Laboratory, Erzsébet hospital , Sátoraljaújhely, Hungary
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Guetl K, Raggam RB, Muster V, Gressenberger P, Vujic J, Avian A, Hafner F, Wehrschuetz M, Brodmann M, Gary T. 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:jcm8101593. [PMID: 31581728 PMCID: PMC6832925 DOI: 10.3390/jcm8101593] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 09/19/2019] [Accepted: 09/27/2019] [Indexed: 01/22/2023] Open
Abstract
Background: The white blood cell count to mean platelet volume ratio (WMR) is increasingly gaining importance as a promising prognostic marker in atherosclerotic disease, but data on lower extremity artery disease (LEAD) are not yet available. The principle aim of this study was to assess the association of the WMR with the occurrence of CLTI (chronic limb-threatening ischemia) as the most advanced stage of disease. Methods: This study was performed as a retrospective analysis on 2121 patients with a diagnosis of LEAD. Patients were admitted to the hospital for the reason of LEAD and received conservative or endovascular treatment. Blood sampling, in order to obtain the required values for this analysis, was implemented at admission. Statistical analysis was conducted by univariate regression in a first step and, in case of significance, by multivariate regression additionally. Results: Multivariate regression revealed an increased WMR (p < 0.001, OR (95%CI) 2.258 (1.460–3.492)), but also advanced age (p < 0.001, OR (95%CI) 1.050 (1.040–1.061)), increased CRP (p < 0.001, OR (95%CI) 1.010 (1.007–1.014)), and diabetes (p < 0.001, OR (95%CI) 2.386 (1.933–2.946)) as independent predictors for CLTI. Conclusions: The WMR presents an easily obtainable and cost-effective parameter to identify LEAD patients at high risk for CLTI.
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Affiliation(s)
- Katharina Guetl
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Reinhard Bernd Raggam
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Viktoria Muster
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Paul Gressenberger
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Jovan Vujic
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036 Graz, Austria.
| | - Franz Hafner
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Martin Wehrschuetz
- Department of Radiology, Medical University of Graz, 8036 Graz, Austria.
| | - Marianne Brodmann
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
| | - Thomas Gary
- Division of Vascular Medicine, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria.
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22
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Savchenko AA, Pavlova OM, Khalo NV, Gvozdev II. [Neutrophil respiratory burst and the state of hemostasis in patients with ischemic and hemorrhagic stroke]. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 118:75-80. [PMID: 30830121 DOI: 10.17116/jnevro201811812275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AIM To study the relationship between the state of the respiratory burst of neutrophils and the indices of hemostasis in patients with ischemic (IS) and hemorrhagic (HS) strokes. MATERIAL AND METHODS Thirty-three patients with IS and 31 patients with HS were examined in the first 24 hours after an acute cerebrovascular accident (ACA). The diagnosis of ASA was confirmed by neuroimaging methods: computed tomography and magnetic resonance imaging. The determination of the respiratory burst state of blood neutrophils was carried out using chemiluminescence analysis. Indicators of vascular-platelet and coagulation hemostasis were determined in all patients. RESULTS AND CONCLUSION There were changes in the kinetics and activity of neutrophil respiratory burst in stroke patients. Patients with HS had higher (compared to those of patients with IS) level of spontaneous and induced synthesis of secondary ROS but with a decrease in metabolic resources for their synthesis. Activation of spontaneous and ADP-induced platelet aggregation was detected only in HS. Patients with HS had a higher level of fibrinolytic activity as compared to the patients with IS. There were positive correlations between the kinetic parameters of blood coagulation and the synthesis of primary ROS by neutrophils in patients with HS, whereas the intensity of all ROS synthesis negatively correlated with activated partial thromboplastin time. Therefore, in patients with HS the synergistic relationship between the respiratory burst of neutrophils (pro-inflammatory activity) and coagulation hemostasis was more pronounced compared to patients with IS.
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Affiliation(s)
- A A Savchenko
- Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences, Research Institute of Medical Problems of the North', Krasnoyarsk, Russia
| | - O M Pavlova
- Non State Healthcare Institution 'Railway Clinical Hospital on Station Krasnoyarsk Open Joint-stock Company 'RRW', Krasnoyarsk, Russia
| | - N V Khalo
- Krasnoyarsk State Budget Healthcare Institution 'Berzon Krasnoyarsk Interdistrict Clinical Hospital #20', Krasnoyarsk, Russia
| | - I I Gvozdev
- Krasnoyarsk Science Center of the Siberian Branch of the Russian Academy of Sciences, Research Institute of Medical Problems of the North', Krasnoyarsk, Russia
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Yilmaz AB, Gokhan S, Sener A, Erel O. Analysis of Neutrophil/Lymphocyte ratio and Thiol/Disulfide homeostasis parameters in patients admitted to the emergency department with ischemic stroke. Pak J Med Sci 2018; 34:1418-1423. [PMID: 30559796 PMCID: PMC6290218 DOI: 10.12669/pjms.346.16242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Objectives: It is known that the neutrophil/lymphocyte ratio (NLR) is associated with adverse outcomes in ischemic stroke patients. We aimed to reveal the association of NLR and thiol/disulfide homeostasis (TDH) with ischemic stroke patients. Methods: This study was conducted prospectively at tertiary hospital in emergency department between March 18, 2017 and November 30, 2017. It included 143 patients who were diagnosed with stroke, exhibited no hemorrhage on the Computed Tomography (CT) of the head were included in the study. Complete blood count, biochemical, TDH parameters and Ischemia Modified Albumin (IMA) were studied. Results: Neutrophil count and NLR were significantly higher in the patient group (p<0.001, p=0.001, respectively). The mean Native Thiol (NT) value of the patient group was 359.9 ± 84.59 μmol/L. The mean Total Thiol (TT) value in the patient group was 399.38 ± 86.06 μmol/L. The NT and TT values in the patient group were significantly lower (NT/TT: p = 0.002/p = 0.007), whereas NLR and IMA were significantly higher in the patient group (p = 0.001/p < 0.001). Conclusions: Physicians should focus on patients with increased NLR, as these patients appear to represent a population at risk for increased morbidity. We have quantitatively demonstrated in tissue oxidative stress level with TDH parameters. Investigation of these new parameters should be continued for the determination of prognostic significance.
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Affiliation(s)
- Aysel Begum Yilmaz
- Aysel Begum Yilmaz, MD. Ankara Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey
| | - Servan Gokhan
- Servan Gokhan, MD. Yildirım Beyazit University Medical School, Department of Emergency Medicine, Ankara, Turkey
| | - Alp Sener
- Alp Sener, MD. Ankara Ataturk Training and Research Hospital, Department of Emergency Medicine, Ankara, Turkey
| | - Ozcan Erel
- Ozcan Erel, MD. Yildirim Beyazit University Medical School, Department of Emergency Medicine, Ankara, Turkey
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24
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Celik H, Duzenli U, Aslan M, Altiparmak IH, Kirmit A, Kara E, Karakilcik AZ. The relationship between platelet indices and ABO blood groups in healthy adults. J Clin Lab Anal 2018; 33:e22720. [PMID: 30461052 DOI: 10.1002/jcla.22720] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 10/23/2018] [Accepted: 10/24/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND ABO blood groups have been suggested to have a high correlation with cardiovascular diseases (CVDs). It has also been postulated that platelet indices, including mean platelet volume (MPV) and platelet distribution width (PDW), are very important in the development and progression of CVDs. However, despite these common associations with CVDs, as far as we know, there are no studies investigating platelet indices in ABO blood groups. Thus, the aim of this study was to investigate whether platelet indices are associated with ABO blood groups. METHODS The study included 301 healthy volunteers (99 women and 202 men; mean age: 32.59 ± 7.52 years) whose blood groups were determined by the gel column method using agglutination techniques. Platelet indices were studied by an automated blood counter. RESULTS No considerable differences in age, gender, or Rh factors were observed among ABO blood groups. MPV was detected to be considerably lower in O and A blood group subjects than in AB and B blood group subjects. Similarly, PDW was significantly lower in O and A blood group subjects than in B blood group subjects. Additionally, MPV in the O blood group subjects was significantly lower than in the non-O blood group subjects. CONCLUSIONS Because MPV and PDW are used as markers of CVDs, individuals with O and A blood groups in this study may be considered to have a lower risk of CVDs than AB and B blood group subjects. However, prospective cohort studies involving a greater number of volunteers are needed to elucidate these relationships.
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Affiliation(s)
- Hakim Celik
- Department of Physiology, Medical Faculty, Harran University, Sanliurfa, Turkey
| | - Ufuk Duzenli
- Department of Otorhinolaryngology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Mehmet Aslan
- Department of Internal Medicine, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | | | - Adnan Kirmit
- Department of Clinical Biochemistry, Medical Faculty, Harran University, Sanliurfa, Turkey
| | - Erdal Kara
- Department of Haematology, Medical Faculty, Yuzuncu Yıl University, Van, Turkey
| | - Ali Ziya Karakilcik
- Department of Physiology, Medical Faculty, Harran University, Sanliurfa, Turkey
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25
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Angkananard T, Anothaisintawee T, McEvoy M, Attia J, Thakkinstian A. Neutrophil Lymphocyte Ratio and Cardiovascular Disease Risk: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2018; 2018:2703518. [PMID: 30534554 PMCID: PMC6252240 DOI: 10.1155/2018/2703518] [Citation(s) in RCA: 175] [Impact Index Per Article: 29.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/13/2018] [Accepted: 10/28/2018] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This systematic review aimed to measure the association between neutrophil lymphocyte ratio (NLR) and cardiovascular disease (CVD) risk. METHODS Relevant studies were identified from Medline and Scopus databases. Observational studies with NLR as a study factor were eligible for review. The outcomes of interest were any type of CVD including acute coronary syndrome, coronary artery disease, stroke, or a composite of these cardiovascular events. Mean differences in NLR between CVD and non-CVD patients were pooled using unstandardized mean difference (USMD). Odds ratios of CVD between high and low NLR groups were pooled using a random effects model. RESULTS Thirty-eight studies (n=76,002) were included. High NLR was significantly associated with the risks of CAD, ACS, stroke, and composite cardiovascular events with pooled ORs of 1.62 (95% CI: 1.38-1.91), 1.64 (95% CI: 1.30, 2.05), 2.36 (95% CI: 1.44, 2.89), and 3.86 (95% CI: 1.73, 8.64), respectively. In addition, mean NLRs in CAD, ACS, and stroke patients were significantly higher than in control groups. CONCLUSION High NLR was associated with CAD, ACS, stroke, and composite cardiovascular events. Therefore, NLR may be a useful CVD biomarker.
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Affiliation(s)
- Teeranan Angkananard
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
- Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, HRH Princess Maha Chakri Sirindhorn Medical Center, Srinakharinwirot University, Nakhon Nayok, Thailand
| | - Thunyarat Anothaisintawee
- Department of Family Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Mark McEvoy
- Center for Clinical Epidemiology and Biostatistics, The School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - John Attia
- Center for Clinical Epidemiology and Biostatistics, The School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia
| | - Ammarin Thakkinstian
- Section for Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Affiliation(s)
- Tarik Yildirim
- a Department of Cardiology, Faculty of Medicine , Muğla Sıtkı Koçman University , Mugla , Turkey
| | - Fatih Akin
- a Department of Cardiology, Faculty of Medicine , Muğla Sıtkı Koçman University , Mugla , Turkey
| | - Ibrahim Altun
- a Department of Cardiology, Faculty of Medicine , Muğla Sıtkı Koçman University , Mugla , Turkey
| | - Seda Elcim Yildirim
- a Department of Cardiology, Faculty of Medicine , Muğla Sıtkı Koçman University , Mugla , Turkey
| | - Ozcan Basaran
- a Department of Cardiology, Faculty of Medicine , Muğla Sıtkı Koçman University , Mugla , Turkey
| | - Mustafa Ozcan Soylu
- a Department of Cardiology, Faculty of Medicine , Muğla Sıtkı Koçman University , Mugla , Turkey
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27
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Yilmaz E, Bayram Kacar A, Bozpolat A, Zararsiz G, Gorkem BS, Karakukcu M, Patiroglu T, Gumus H, Ozdemir MA, Ozcan A, Per H, Unal E. The relationship between hematological parameters and prognosis of children with acute ischemic stroke. Childs Nerv Syst 2018; 34:655-661. [PMID: 29209887 DOI: 10.1007/s00381-017-3673-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 11/27/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Stroke is rarely seen in children, but it is a major cause of morbidity and mortality. Therefore, there is a need for inexpensive and noninvasive diagnostic methods for estimating the prognosis. Although the prognostic importance of hematological parameters in acute ischemic stroke were reported in adult studies, there is a lack in pediatric ages. The aim of the study is to investigate the relationship between hematological parameters and prognosis of acute ischemic stroke in children. METHODS Retrospectively scanned in the study were 106 pediatric patients with acute ischemic stroke who managed at the Medical Faculty of Erciyes University, Kayseri, between the years of 2000 and 2014. White blood count (WBC); neutrophil, lymphocyte, and platelet count; mean platelet volume (MPV); platelet distribution width (PDW); neutrophil count/lymphocyte count (N/L) ratio values obtained from the measurements and initial symptoms; demographical features; risk factors; neurological examination; and clinical follow-up were recorded. Their hematological parameters were compared with those of 106 age and sex-matched healthy individuals. RESULTS MPV and PDW values were found similar in patient and control groups, and the platelet count was found significantly low in the control group (p = 0,028). WBC, neutrophil count, and N/L ratio were found considerably high in the patient group (p < 0.001). Lymphocyte count, however, was found significantly low in the control group (p < 0.001). No statistically significant difference was detected in WBC, neutrophil count, lymphocyte count, platelet count, N/L ratio, and MPV and PDW values between the group with sequelae and the one without sequelae. In addition, it was determined that WBC, neutrophil count, lymphocyte count, platelet count, N/L ratio, and MPV and PDW values in the univariate Cox-regression analysis of the patient group had no effect on survival and disease-free survival. When receiver operating characteristic curve was applied, it was observed that the area below WBC, N/L ratio curve was important in the patient group in terms of predicting acute ischemic stroke. CONCLUSION The values of WBC, neutrophil count, and N/L ratio differ significantly from those of the control group. The WBC and N/L ratio may help for an earlier diagnosis in children with acute ischemic stroke. WBC, thrombocyte count, MPV, PDW, and N/L ratio do not constitute a risk in overall survival, disease-free survival, and sequelae development.
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Affiliation(s)
- Ebru Yilmaz
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Erciyes University, 38039, Talas, Kayseri, Turkey
| | - Ayse Bayram Kacar
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Erciyes University, Kayseri, Turkey
| | - Adil Bozpolat
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Erciyes University, 38039, Talas, Kayseri, Turkey
| | - Gokmen Zararsiz
- Faculty of Medicine, Department of Biostatistics and Medical Informatics, Erciyes University, Kayseri, Turkey
| | - Burcu S Gorkem
- Faculty of Medicine, Department of Radiology, Division of Pediatric Radiology, Erciyes University, Kayseri, Turkey
| | - Musa Karakukcu
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Erciyes University, 38039, Talas, Kayseri, Turkey
| | - Turkan Patiroglu
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Erciyes University, 38039, Talas, Kayseri, Turkey
| | - Hakan Gumus
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Erciyes University, Kayseri, Turkey
| | - Mehmet Akif Ozdemir
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Erciyes University, 38039, Talas, Kayseri, Turkey
| | - Alper Ozcan
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Erciyes University, 38039, Talas, Kayseri, Turkey
| | - Huseyin Per
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Neurology, Erciyes University, Kayseri, Turkey
| | - Ekrem Unal
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Erciyes University, 38039, Talas, Kayseri, Turkey.
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28
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Farah R, Samra N. Mean platelets volume and neutrophil to lymphocyte ratio as predictors of stroke. J Clin Lab Anal 2017; 32. [PMID: 28303662 DOI: 10.1002/jcla.22189] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 01/28/2017] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Mean platelets volume (MPV) is a marker, which indicates platelet function, and is a potential link between inflammation and thrombosis. Previous studies have found a relation between high MPV levels and high risk of stroke. Another factor that has been associated with the risk of stroke is neutrophil to lymphocyte ratio (NLR). Several studies have reported an association between increased NLR and increased risk of cerebrovascular disease. It was found that NLR levels have a relation to the prognosis as well. Since both NLR and MPV have been associated with increased risk of cardiovascular disease, together they may predict the risk of stroke and the prognosis with higher sensitivity and specificity. METHODS This is a descriptive retrospective study. Data were gathered from medical records of patients who applied the Ziv medical center and were diagnosed with stroke. Stroke severity was evaluated using the NIHSS (national institutes of health stroke scale). MPV and NLR levels of patients with stroke were compared to those of 30 healthy individuals. RESULTS Neutrophil to lymphocyte ratio levels were found significantly higher in patients with stroke compared with healthy individuals. NLR was also found higher in patients with moderate/severe stroke compared with those with minor stroke. No association was found between MPV level, the risk of stroke, and stroke prognosis. Moreover, an interaction effect between MPV and NLR level was not found. CONCLUSION Neutrophil to lymphocyte ratio is a good predictive factor of stroke and stroke prognosis. Further prospective studies are needed to establish the relationship between the MPV level and the risk of stroke. NLR and MPV interaction effect can be tested again in the future after establishing the association between MPV, the risk of stroke, and stroke prognosis.
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Affiliation(s)
- Raymond Farah
- Department of Internal Medicine B, Ziv Medical Center, Safed, Israel.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
| | - Nava Samra
- Department of Internal Medicine B, Ziv Medical Center, Safed, Israel.,Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
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