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Stereological and Flow Cytometry Characterization of Leukocyte Subpopulations in Models of Transient or Permanent Cerebral Ischemia
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Prognostic value of lymphocyte-to-monocyte ratio in acute ischemic stroke: a systematic review and meta-analysis

Chengli Tian1,2, Yilin Yang1,2, Jun Wan2

  • 1Center for Evidence-Based Medicine, Affiliated Hospital of Chengdu University, Chengdu, Sichuan, China.

Frontiers in Neurology
|May 22, 2025
PubMed
Abstract

Insights

Lower lymphocyte-to-monocyte ratio (LMR) is linked to worse outcomes in acute ischemic stroke (AIS) patients. This meta-analysis confirms LMR as a prognostic factor for functional recovery after AIS.

Area of Science:

  • Neurology
  • Hematology
  • Biostatistics

Background:

  • Prognostic relevance of lymphocyte-to-monocyte ratio (LMR) in acute ischemic stroke (AIS) shows variability.
  • Previous studies on LMR in AIS prognosis have yielded inconsistent findings.

Purpose of the Study:

  • To conduct a meta-analysis to determine the prognostic significance of LMR in patients with AIS.
  • To synthesize existing evidence on the association between LMR and clinical outcomes in AIS.

Main Methods:

  • Meta-analysis of six trials including 1,225 patients with AIS.
  • Data synthesized using random-effects model, with odds ratios (ORs) and 95% confidence intervals (CIs).
  • Poor functional outcome (modified Rankin Scale score ≥3) at 3 months was the primary outcome.

Main Results:

  • Lower LMR significantly correlated with poorer functional outcome at 3 months in AIS patients (OR 0.63, 95% CI: 0.49-0.80, p=0.0002).
  • Lower LMR was associated with moderate to severe stroke (OR 0.89, 95% CI: 0.82-0.97, p=0.008).
  • Subgroup analyses and country-stratified analyses (Asian populations) reinforced the association between lower LMR and worse functional outcomes.

Conclusions:

  • Lymphocyte-to-monocyte ratio (LMR) serves as a significant prognostic factor for clinical outcomes in patients with acute ischemic stroke (AIS).
  • LMR can aid in predicting functional recovery and stroke severity in AIS patients.
Keywords:
AISLMRacute ischemic strokelymphocyte-to-monocytepoor functional outcomeprognosisstroke

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