Platelet-lymphocyte ratio correlation with post-thrombolysis symptomatic intracerebral hemorrhage in acute ischemic stroke

Abstract Background and Purpose To investigate the association between the platelet to lymphocyte ratio (PLR) and the development of symptomatic intracranial hemorrhage (sICH) following intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) patients. Methods A retrospective, consecutive cohort study was conducted on AIS patients who underwent IVT with recombinant tissue plasminogen activator (rtPA). Within 24 h after thrombolysis, blood samples were collected from all patients, and subsequent measurements were taken of their platelet and lymphocyte counts. sICH was diagnosed based on the deterioration of neurological symptoms within 24 h after thrombolysis and the imaging results of cranial computed tomography (CT) or magnetic resonance imaging (MRI). Univariate and multivariate logistic regression analyses were performed to ascertain the association between PLR and sICH. The receiver operating characteristic (ROC) curve was used to assess the clinical predictive utility of PLR for sICH. Results With 291 patients who received IVT treatment, among which 17 (5.84%) patients experienced sICH. The median PLR for sICH group was 180, markedly exceeding that of the no sICH group, with a statistically significant difference [180 (132.94, 254.55) versus 111.91 (88.12, 151.08), P < 0.05]. Binary logistic regression analysis indicated an independent association between PLR and post-thrombolysis sICH in patients with AIS (OR 1.009 (1.003–1.015), P < 0.05). The area under the ROC curve (AUC) for PLR in predicting sICH was 0.723 (0.568–0.877), with an optimal cut-off value of 174.72. Conclusion PLR was association with post-thrombolysis sICH in patients.