Early prediction of severity in acute ischemic stroke and transient ischemic attack using platelet parameters and neutrophil-to-lymphocyte ratio

J Clin Lab Anal. 2019 Mar;33(3):e22714. doi: 10.1002/jcla.22714. Epub 2018 Nov 9.

Abstract

Background: It is still not easy to predict severity promptly in patients with acute ischemic stroke (AIS) and transient ischemic attack (TIA). We investigated that platelet parameters or combinations of them could be a useful tool for early prediction of severity of AIS and TIA at admission and after 3 months.

Methods: We prospectively recruited 104 patients newly diagnosed with AIS and TIA. We investigated their neutrophil-to-lymphocyte ratio (NLR) and platelet parameters. According to the Modified Rankin Scale scores, the patients were divided into two groups.

Results: In receiver operating characteristic (ROC) curve analyses, mean platelet volume (MPV), NLR/platelet count (PLT), MPV/PLT, MPV*NLR, and MPV*NLR/PLT showed statistically significant results in both at admission and after 3 months. Values of area under ROC curves for those tests at admission were 0.646, 0.697, 0.664, 0.708, and 0.722, respectively. Also, values after 3 months were 0.591, 0.661, 0.638, 0.662, and 0.689, respectively.

Conclusion: MPV*NLR/PLT could be used as a relatively good tool for predicting severity at the time of admission and after 3 months than other parameters or combinations of them. Further studies have to be carried out to investigate the best parameter for predicting the severity of AIS and TIA.

Keywords: acute ischemic stroke; mean platelet volume; neutrophil-to-lymphocyte ratio; platelet count; platelet parameter; transient ischemic attack.

MeSH terms

  • Aged
  • Female
  • Humans
  • Ischemic Attack, Transient / blood
  • Ischemic Attack, Transient / diagnosis*
  • Ischemic Attack, Transient / epidemiology
  • Leukocyte Count*
  • Lymphocytes / cytology
  • Male
  • Middle Aged
  • Neutrophils / cytology
  • Platelet Function Tests*
  • Prospective Studies
  • ROC Curve
  • Stroke / blood
  • Stroke / diagnosis*
  • Stroke / epidemiology