Analysis of the correlation between neutrophil percentage-to-albumin ratio, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio with short-term prognosis in acute ischemic stroke patients undergoing intravenous thrombolysis.

Introduction: The purpose of this study was to evaluate the association between four easy-to-measure inflammatory markers and the 90-day outcomes with acute ischemic stroke (AIS) patients who received intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA). These included the neutrophil percentage-to-albumin ratio (NPAR), the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), and the combined NPAR+NLR index. Methods: This study enrolled 151 AIS patients who were treated with rt-PA (0.9 mg/kg). Clinical data were collected and NPAR, NLR, PLR were calculated from the admission blood work. The patients were followed up for 90 days after stroke onset and subsequently categorized into two groups based on the modified Rankin Scale (mRS): a favorable outcome group (111 patients, mRS ≤ 2) and a poor outcome group (40 patients, mRS > 2). Results: In this study, we foud elevated level of albumin and lymphocyte counts are protective factors for short-term prognosis. Age, neutrophil percentage, NPAR, NLR, PLR, NIHSS score, and fasting blood glucose (FBG) are associated with poor short-term prognosis. Among these, age, NPAR, NLR, and NIHSS score are independent risk factors for poor short-term prognosis. Discussion: NPAR, NLR, PLR, and the combined NPAR+NLR index may have predictive value for poor short-term outcomes in AIS patients following thrombolysis. NPAR demonstrates the highest predictive capability, in the following order: NPAR > NPAR+NLR > NLR > PLR.