Low neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios predict favorable outcomes after endovascular treatment in acute basilar artery occlusion: subgroup analysis of the BASILAR registry

• Published in: BMC neurology 2023-03, Vol.23 (1), p.113-113, Article 113
• Main Authors: Liao, Jia Sheng, Guo, Changwei, Zhang, Bo, Yang, Jie, Zi, Wenjie, Li, Jing Lun
• Format: Article
• Language: English
• Subjects: Arterial occlusions; Arterial Occlusive Diseases - therapy; Basilar Artery; Basilar artery occlusion; Biomarkers; Blood; Blood Platelets; Cardiovascular disease; Cardiovascular system; Care and treatment; Diabetes; Diagnosis; Endovascular Procedures - adverse effects; Endovascular stents; Endovascular treatment; Etiology; Health aspects; Humans; Inflammation; Laboratories; Leukocytes (neutrophilic); Lymphocytes; Measurement; Mortality; Neutrophil-to-lymphocyte ratio; Neutrophils; Occlusion; Patients; Platelet-to-lymphocyte ratio; Platelets; Ratios; Registries; Risk factors; Stroke; Treatment Outcome; Veins & arteries
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-023-03161-2

Recently, the BAOCHE trial and ATTENTION trial registry have demonstrated the efficacy of endovascular treatment (EVT) in patients with acute basilar artery occlusion (BAO), however, the proportion of patients with favorable post-EVT outcomes remains low. The present study aimed to investigate the individual and joint prognostic values of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with acute BAO who have undergone EVT. We enrolled patients who underwent EVT from the BASILAR registry. Patients were divided into the following groups based on their modified Rankin Scale (mRS) scores at 90 days: favorable-outcome (mRS score: 0-3) and poor-outcome (mRS score: 4-6) groups. Multivariable logistic regression was performed to analyze the association of NLR and PLR with favorable post-EVT outcomes. In total, 585 patients with EVT were recruited. Of these, 189 and 396 patients were in the favorable-outcome and poor-outcome groups, respectively. According to the multivariable logistic regression analyses, both NLR (adjusted odds ratio [aOR], 0.950; 95% confidence interval [CI], 0.920-0.981; P = 0.002) and PLR (aOR, 0.997; 95% CI, 0.995-0.999; P = 0.002) were related to favorable post-EVT outcomes in patients with acute BAO. The optimal cutoff values for the NLR and PLR were 7.75 and 191, respectively. Furthermore, stratified analysis using the multivariable logistic regression model revealed that both NLR and PLR (NLR values ≥ 7.75 and PLR values ≥ 191) were associated with a low rate of favorable outcomes (aOR, 0.292; 95% CI, 0.173-0.494; P