Early elevated neutrophil-to-lymphocyte ratio associated with remote diffusion-weighted imaging lesions in acute intracerebral hemorrhage.

Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101473265 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1755-5949 (Electronic) Linking ISSN: 17555930 NLM ISO Abbreviation: CNS Neurosci Ther Subsets: MEDLINE

Original Publication: Oxford, UK : Wiley-Blackwell, c2008-

Cerebral Hemorrhage/*blood ; Cerebral Hemorrhage/*diagnostic imaging ; Diffusion Magnetic Resonance Imaging/*methods ; Lymphocytes/*metabolism ; Neutrophils/*metabolism; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Retrospective Studies

Aims: To explore the relationship between the circulating neutrophil-to-lymphocyte ratio (NLR) and the remote diffusion-weighted imaging lesions (R-DWILs) after spontaneous intracerebral hemorrhage (ICH).
Methods: Consecutive patients with spontaneous ICH were prospectively collected from November 2016 to May 2018 and retrospectively analyzed. We included subjects who presented within 24 hours after symptom onset and were free of detectable infections on admission or in hospital. Blood samples were obtained at 24-48 hours after ICH ictus, while all complete MRI scans were performed at 5-8 days. R-DWILs were defined as focal hyperintensities remote from the site of the ICH or the peri-hematoma regions. NLR was calculated by dividing the absolute neutrophil counts by the absolute lymphocyte counts. Multivariate binary logistic regression models were generated to evaluate the relationship between NLR and R-DWILs.
Results: One hundred sixty-three subjects met eligibility criteria (age 62.3 ± 13.6 years, 60.7% males), of whom 31(19.0%) experienced R-DWILs. Higher circulating NLR was documented in patients with R-DWILs. With the best cutoff value of 6.01, elevated NLR was independently associated with the presence of R-DWILs (OR = 3.170, 95% CI 1.306-7.697, P = .011) in the bivariate logistic regression analysis with adjustment for age, sex, atrial fibrillation, previous ischemic stroke/TIA, SBP on admission, hematoma volume, and IVH.
Conclusions: This study provides significant evidence of the association between circulating NLR and R-DWILs in spontaneous ICH patients. Patients with NLR > 6.01 at 24-48 hours after ICH ictus should be paid more attention to when evaluating R-DWILs.
(© 2019 The Authors. CNS Neuroscience & Therapeutics published by John Wiley & Sons Ltd.)

Nat Rev Neurosci. 2005 Oct;6(10):775-86. (PMID: 16163382)
J Cereb Blood Flow Metab. 2007 May;27(5):894-908. (PMID: 17033693)
Clin Cancer Res. 2011 Nov 15;17(22):6992-7002. (PMID: 21948231)
Stroke. 2009 Feb;40(2):394-9. (PMID: 19038914)
Eur Rev Med Pharmacol Sci. 2013 Mar;17(5):653-7. (PMID: 23543449)
Ann Neurol. 2012 Feb;71(2):199-205. (PMID: 22367992)
Neurology. 2012 Dec 11;79(24):2335-41. (PMID: 23197745)
J Cereb Blood Flow Metab. 2019 Jan;39(1):184-186. (PMID: 30346222)
J Neurol Sci. 2017 Sep 15;380:226-229. (PMID: 28870575)
Neurology. 2012 Jul 24;79(4):314-9. (PMID: 22744655)
Neurology. 2017 Oct 10;89(15):1553-1560. (PMID: 28887375)
Neurology. 2017 Feb 21;88(8):782-788. (PMID: 28122903)
Stroke. 2016 Jun;47(6):1654-7. (PMID: 27165957)
CNS Neurosci Ther. 2019 Jun;25(6):674-684. (PMID: 30677253)
Stroke. 1993 Jul;24(7):987-93. (PMID: 8322400)
Brain. 2005 Jul;128(Pt 7):1622-33. (PMID: 15800021)
Stroke. 2016 Jun;47(6):1473-8. (PMID: 27103016)
Stroke. 2019 Jan;50(1):135-142. (PMID: 30580720)
J Cereb Blood Flow Metab. 2015 Oct;35(10):1657-63. (PMID: 25966956)
Stroke. 2012 Aug;43(8):2258-63. (PMID: 22821611)
Neurology. 2015 Dec 8;85(23):2045-52. (PMID: 26546632)
Bratisl Lek Listy. 2001;102(1):5-14. (PMID: 11723675)
Brain. 2011 Aug;134(Pt 8):2376-86. (PMID: 21841203)
Angiology. 2015 Jul;66(6):545-52. (PMID: 25024461)
PLoS One. 2014 Aug 28;9(8):e105970. (PMID: 25166754)
Stroke. 1996 Aug;27(8):1304-5. (PMID: 8711791)
Stroke. 2016 Apr;47(4):1165-72. (PMID: 26786115)
J Cereb Blood Flow Metab. 2019 Jun;39(6):959-988. (PMID: 30961425)
CNS Neurosci Ther. 2020 Apr;26(4):430-437. (PMID: 31651093)
Stroke. 2017 Sep;48(9):2589-2592. (PMID: 28698256)
Stroke. 2002 Sep;33(9):2334-5. (PMID: 12215608)
Haematologica. 2017 Feb;102(2):206-213. (PMID: 27927771)
J Cereb Blood Flow Metab. 1999 Sep;19(9):1004-9. (PMID: 10478652)
CNS Neurosci Ther. 2019 Jan;25(1):30-35. (PMID: 29767470)
Stroke. 2001 Apr;32(4):891-7. (PMID: 11283388)
Stroke. 2012 Jan;43(1):67-71. (PMID: 21980211)
Am J Emerg Med. 2017 Mar;35(3):429-433. (PMID: 27876538)
J Neurointerv Surg. 2019 Nov;11(11):1135-1140. (PMID: 30979846)
Neurology. 2012 Aug 28;79(9):848-55. (PMID: 22843271)

Keywords: biomarker; diffusion-weighted imaging (DWI); intracerebral haemorrhage (ICH); neutrophil-to-lymphocyte ratio (NLR)

Date Created: 20191026 Date Completed: 20210629 Latest Revision: 20240328

20240329

PMC7080428

10.1111/cns.13249

31651093