Prognostic value of dynamic changes in neutrophil-to-lymphocyte ratio and high-sensitivity troponin I after...

Dynamic changes in inflammatory and cardiac biomarkers following acute ischemic stroke may better reflect the underlying pathophysiological response than static measurements. However, their prognostic significance after successful mechanical thrombectomy remains unclear.

The study was designed as a retrospective cohort study and included 48 patients with large vessel occlusion who underwent successful endovascular recanalization (TICI 2b-3) treatment at a tertiary stroke center and were dynamically monitored with troponin and complete blood count tests. NLR and hs-cTnI (ng/L) values were evaluated before the procedure and repeated 16-24 hours later.

In the first regression model, unfavorable (mRS 3-6) outcome,   age and NLR at 16-24 h showed results close to statistical significance (p = .056 and .061, respectively)  and the model was found to be significant (p < .001, Nagelkerke R²: 0.567, AUC = 0.883). In the second regression model, which evaluated functional dependency or mortality (mRS: 4-6)  NLR at 16-24 h were found to be significantly predictive (p = .041), and the model was evaluated as significant (p < .001, Nagelkerke R² = 0.613 and AUC = 0.924). ΔNLR was found to be positively and significantly associated with mRS 4-6, and Δ hs-cTnI was found to be positively and significantly associated with both mRS 4-6 and mRS 6 (p < .05).  .

Early dynamic increases ΔNLR and Δ hs-cTnI were significantly tied to functional dependence and mortality only in unadjusted analyses. Due to sample size limitations and multicollinearity, the independent prognostic value of these dynamic shifts remains exploratory and requires validation in larger and adjusted cohorts.