Eosinophil: A New Circulating Biomarker for Risk of Poor Outcome in Stroke Patients Undergoing Mechanical Thrombectomy

OBJECTIVE: Acute ischemic stroke (AIS), caused by occlusion of large vessel, is a serious life-threatening disease. This study aimed to comprehensively investigate the association of 14 common and readily available circulating biomarkers with the 90-day modified Rankin Scale (mRS) score in patients undergoing mechanical thrombectomy (MT). METHODS: This study included patients with anterior circulation large vessel occlusive stroke treated with MT from 05/2017 to 12/2021. Baseline comparisons of poor outcome were performed among enrolled patients. Factors that may be associated with the mRS score were assessed using correlation analysis. Univariate and multivariate logistic regression analyses were used to evaluate the predictive value of circulating biomarkers and poor outcome. RESULTS: The mRS score has a strong correlation with neutrophil to lymphocyte ratio (NLR) and eosinophil levels (all r(s)>0.4 in absolute value and all P<0.001) in addition to a high correlation with National Institute of Health Stroke Scale (NIHSS) score (r(s)=0.40, P<0.001). There was also a high correlation between NLR and eosinophil (r(s)=−0.58, P<0.001). In the multivariate regression analysis, only neutrophil (adjusted OR=1.301, 95% CI: 1.155−1.465, P<0.001), eosinophil (adjusted OR<0.001, 95% CI: <0.001−0.016, P<0.001), and NLR (adjusted OR=1.158, 95% CI: 1.082−1.241, P<0.001) were independently associated with poor outcome. CONCLUSION: This study evaluated a series of circulating biomarkers and found that neutrophil, eosinophil, and NLR independently predicted poor outcome after MT in AIS patients. There was a significant negative correlation between eosinophil and NLR levels.