The association between neutrophil to lymphocyte ratio and covert brain infarction after carotid endarterectomy: a single center retrospective study.

BACKGROUND

Neutrophil to lymphocyte ratio (NLR) is a biomarker which is related with inflammation and atherosclerosis. Higher NLR is associated with vulnerability of carotid atherosclerotic plaques. Covert brain infarction (CBI) following carotid endarterectomy (CEA) indicates poor prognosis in cognization. In this study, we aimed to investigate the relationship between NLR and CBI in patients who accepted CEA.

METHODS

In this observational and retrospective cohort study, 333 patients who underwent CEA due to severe carotid artery stenosis were enrolled. NLR was acquired from routine blood tests upon admission. Postoperative CBI was detected on magnetic resonance imaging. Logistic regression analysis was used to examine the association between NLR and CBI.

RESULTS

Patients with CBI had higher NLR (CBI patients: 2.45[1.76-3.58] vs. non-CBI patients: 2.31[1.82-2.88]; P = 0.05). NLR is a strong independent factor predicting the risk of CBI following CEA (odds ratio [OR], 1.740; 95% confidence interval [CI]: 1.325-2.286; P < 0.001). Furthermore, the predictive risk value by NLR is not affected by other related factors.

CONCLUSIONS

NLR is associated with the risk of CBI in patients underwent CEA. NLR is a convenient and low-cost biomarker that can be used for risk stratification management of perioperative carotid stenosis patients.