Relationship between high-sensitivity C-reactive protein/lymphocyte ratio and post-thrombolysis short-term outcome in...

High-sensitivity C-reactive protein / lymphocyte ratio (hsCLR) was emerged as a promising novel biomarker for various diseases. However, the relationship between hsCLR and short-term outcome in acute ischemic stroke (AIS) patients treated with intravenous thrombolysis (IVT) remained unclear.

This multicenter study included 904 AIS patients undergoing IVT. Multivariate logistic regression and restricted cubic spline (RCS) analysis were used to explore the association between hsCLR levels and unfavorable short-term outcomes after thrombolysis. Receiver operating characteristic (ROC) analysis was performed to evaluate the prognostic performance of hsCLR. Net reclassification improvement (NRI) and integrated discrimination improvement (IDI) analyses were further conducted to assess the incremental prognostic value of adding hsCLR to conventional risk models.

We found that patients with higher levels of lnhsCLR were more likely to experience short-term unfavorable outcome (P < 0.001). The multivariate logistic model revealed that increased levels of lnhsCLR [odds ratio (OR): 2.33, 95% CI (Confidence interval): 1.42-3.81, P < 0.001] were significant associated with short-term unfavorable outcome (hsCLR quartile 4 vs. quartile 1) after the adjustment of confounding factors. RCS analyses exhibited a linear pattern (P for overall = 0.002; P for nonlinear = 0.391). Moreover, NRI and IDI analyses demonstrated that adding lnhsCLR to the conventional risk model provided incremental prognostic value, with an NRI of 21.22% (P = 0.002) and an IDI of 1.21% (P = 0.002).

Elevated baseline hsCLR is associated with unfavorable short-term outcomes and may serve as a promising prognostic biomarker in AIS patients undergoing intravenous thrombolysis.