Eosinophil-to-Monocyte Ratio is a Potential Predictor of Prognosis in Acute Ischemic Stroke Patients After Intravenous Thrombolysis

Clin Interv Aging. 2021 May 17:16:853-862. doi: 10.2147/CIA.S309923. eCollection 2021.

Abstract

Background: Eosinophil and monocyte have been demonstrated separately to be independent predictors of acute ischemic stroke (AIS). This study aimed to evaluate the association between eosinophil-to-monocyte ratio (EMR) and 3-month clinical outcome after treatment with recombinant tissue plasminogen activator (rt-PA) for AIS patients. Simultaneously, we made a simple comparison with other prognostic indicators, such as 24h neutrophil-to-lymphocyte ratio (NLR) and 24h platelet-to-lymphocyte ratio (PLR) to investigate the prognostic value of EMR.

Methods and results: A total of 280 AIS patients receiving intravenous thrombolysis were retrospectively recruited for this study. Complete blood count evaluations for EMR were conducted on 24 hours admission. The poor outcome at 3-month was defined as the modified Rankin Scale (mRS) of 3-6 and the mRS score for death was 6. The EMR levels in patients with AIS were lower than those in the healthy controls and showed a negative correlation with the NIHSS score. At the 3-month follow-up, multivariate logistic regression analysis indicated an association among EMR, poor outcome and mortality. In addition, EMR had a higher predictive ability than popular biomarkers like NLR and PLR for 3-month mortality.

Conclusion: The lower levels of EMR were independently associated with poor outcome and dead status in AIS patients.

Keywords: acute ischemic stroke; eosinophil-to-monocyte ratio; intravenous thrombolysis; modified rankin scale; treatment outcome.

MeSH terms

  • Administration, Intravenous
  • Aged
  • Biomarkers
  • Eosinophils / metabolism*
  • Female
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Ischemic Stroke / blood*
  • Ischemic Stroke / drug therapy*
  • Lymphocytes / metabolism
  • Male
  • Middle Aged
  • Monocytes / metabolism*
  • Neutrophils / metabolism
  • Prognosis
  • Retrospective Studies
  • Thrombolytic Therapy
  • Tissue Plasminogen Activator / therapeutic use*

Substances

  • Biomarkers
  • Fibrinolytic Agents
  • Tissue Plasminogen Activator