Associations of eosinophil-to-monocyte ratio and C-reactive protein-to-high-density lipoprotein cholesterol ratio with early neurological deterioration after thrombolysis in acute ischemic stroke

'Associations' DO NOTHING FOR SURVIVOR RECOVERY! Are you that blitheringly stupid you don't know that survivors would like recovery rather than a completely fucking useless 'association'? 

Had you been thinking at all you would be solving the  5 causes of the neuronal cascade of death in the first week saving hundreds of million to billions of neurons! Thus, preventing early neurological deterioration. Or don't you have two functioning neurons to rub together for a spark of intelligence?

 Associations of eosinophil-to-monocyte ratio and C-reactive protein-to-high-density lipoprotein cholesterol ratio with early neurological deterioration after thrombolysis in acute ischemic stroke

Guohua HeGuilan XuYanqiao XiaoZhen WangYachun Yu^*

• Department of Neurology, The Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, China

Background: Inflammation mechanisms play critical roles in acute ischemic stroke (AIS). However, the correlations of the eosinophil-to-monocyte ratio (EMR) and blood C-reactive protein to high-density lipoprotein cholesterol (CRP/HDL-C) ratio with post-thrombolysis early neurological deterioration (END) in patients with AIS remain uncertain.

Methods: Patients with AIS who received intravenous thrombolysis therapy from January 2020 to February 2025 were retrospectively recruited for this study. CRP level, blood lipid concentrations, and complete blood count measurements were recorded within 24 h of admission. Post-thrombolysis END was defined as an increase in the U.S National Institutes of Health Stroke Scale (NIHSS) score of ≥ 4 points compared to the initial NIHSS score taken within 24 h of initiating intravenous thrombolysis. Multivariate logistic regression modeling was performed to evaluate the correlations of EMR and the CRP/HDL-C ratio to post-thrombolysis END. Receiver operating characteristic (ROC) curves were used to analyze the predictive value of both EMR and the CRP/HDL-C ratio in patients with post-thrombolysis END.

Results: Among 473 recruited patients, 103 (21.78%) were diagnosed with post-thrombolysis END. Patients with END had significantly higher systolic and diastolic blood pressures, white blood cell and monocyte counts, CRP levels, CRP/HDL-C ratios, and NIHSS scores on admission, while their eosinophil counts and EMRs were significantly lower. The multivariate logistic regression analysis indicated that EMR (odds ratio [OR], 0.03 [95% confidence interval (CI) 0.01–0.14]; p < 0.001) and CRP/HDL-C (odds ratio, 1.04[95%CI 1.01–1.08]; p = 0.025) were independently associated with END after adjusting for potential confounders. The areas under the receiver operating characteristic curve (AUC) for EMR and the CRP/HDL-C ratio were 0.757 (95% CI, 0.709–0.805) and 0.61 (95% CI, 0.545–0.675), respectively.

Conclusion: A lower EMR level and a higher CRP/HDL-C ratio in patients with AIS are independently associated with post-thrombolysis END. EMR and the CRP/HDL-C ratio may be potential biomarkers for post-thrombolysis END.

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