Key result
Higher NLR/LDL-C ratio is linked to ~97% higher odds of unfavorable post-thrombectomy outcome.
Why the study?
The prognostic association between the neutrophil-to-lymphocyte ratio divided by low-density lipoprotein cholesterol (NLR/LDL-C ratio) and 90-day functional outcomes in patients with large vessel occlusion-related acute ischemic stroke undergoing endovascular thrombectomy required investigation.
Is the neutrophil-to-lymphocyte ratio/low-density lipoprotein cholesterol (NLR/LDL-C) ratio associated with 90-day functional outcomes in patients with large vessel occlusion acute ischemic stroke treated with endovascular thrombectomy?
Cohort (n=336)
No
Is the neutrophil-to-lymphocyte ratio/low-density lipoprotein cholesterol (NLR/LDL-C) ratio associated with 90-day functional outcomes in patients with large vessel occlusion acute ischemic stroke treated with endovascular thrombectomy?
A higher NLR/LDL-C ratio is independently associated with unfavorable 90-day functional outcomes following endovascular thrombectomy for large vessel occlusion acute ischemic stroke, potentially enhancing clinical risk stratification.
Answers are grounded in this paper and cite their sources.
May refine post-thrombectomy prognosis models; leaves open prospective validation and therapeutic targeting.
Objective To investigate the association between the neutrophil-to-lymphocyte ratio (NLR) divided by low-density lipoprotein cholesterol (LDL-C), termed the NLR/LDL-C ratio, and 90-day functional outcomes in patients with large vessel occlusion-related acute ischemic stroke undergoing endovascular thrombectomy. Methods This single-center retrospective cohort study included patients treated at Beijing Chaoyang Hospital of Capital Medical University, Beijing, China, between January 2022 and December 2024. Patients were classified as having favorable (modified Rankin Scale [mRS] 0-2) or unfavorable (mRS 3-6) functional outcome at 90 days. Baseline demographic, clinical, procedural, and laboratory variables were analyzed. Multivariable logistic regression used a prespecified covariate set and avoided simultaneous entry of the NLR/LDL-C ratio with its component variables to reduce collinearity. Discrimination was assessed using receiver operating characteristic curves. Results A total of 336 patients were analyzed, including 164 with favorable outcomes and 172 with unfavorable outcomes. Compared with the favorable group, the unfavorable group was older (69.3±11.9 vs. 62.8±11.6 years, P<0.001) and had higher admission National Institutes of Health Stroke Scale scores [14 (9, 20) vs. 8 (5, 12), P<0.001]. The unfavorable group also had higher neutrophil counts, higher NLR, lower lymphocyte counts, lower LDL-C, and a higher NLR/LDL-C ratio (all P≤0.012). In the adjusted model (n=315), the NLR/LDL-C ratio remained independently associated with unfavorable outcome (adjusted OR=1.968, 95% CI: 1.601-2.419, P<0.001). The area under the curve improved from 0.827 for Model A to 0.852 for Model B after adding the NLR/LDL-C ratio (DeLong P=0.014). Conclusion The NLR/LDL-C ratio was associated with 90-day unfavorable outcome after endovascular thrombectomy in this retrospective cohort. This composite marker may augment risk stratification, but external validation and analyses accounting for lipid-lowering therapy are required before routine clinical implementation.
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Fu et al. (2026) conducted a cohort in Large vessel occlusion acute ischemic stroke treated with endovascular thrombectomy (n=336). Neutrophil-to-lymphocyte ratio/low-density lipoprotein cholesterol (NLR/LDL-C) ratio was evaluated on 90-day unfavorable functional outcome (modified Rankin Scale 3-6) (OR 1.968, 95% CI 1.601-2.419, p=<0.001). The NLR/LDL-C ratio was independently associated with 90-day unfavorable functional outcome after endovascular thrombectomy (adjusted OR 1.968; 95% CI 1.601-2.419; P<0.001).
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