MINI REVIEW article
Front. Neurol.
Sec. Neurological Biomarkers
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1567112
Prognostic value of lymphocyte-to-monocyte ratio in acute ischemic stroke: A systematic review and meta-analysis
Provisionally accepted
- Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, China
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The findings from studies exploring the prognostic relevance of the lymphocyte-tomonocyte ratio (LMR) in individuals with acute ischemic stroke (AIS) have shown variability. We aimed to conduct a meta-analysis to determine the prognostic significance of LMR in this patient population.We carried out a meta-analysis utilizing information from major databases, including PubMed, Embase, and Web of Science until October 26, 2024. Effect sizes, represented as odds ratios (ORs) along with their corresponding 95% confidence intervals (CI), were synthesized employing a random-effects model in Review Manager Version 5.4. To investigate possible sources of variability, we conducted subgroup analyses. Additionally, publication bias was assessed through the use of a funnel plot. Poor functional outcome at three months, as indicated via a modified Rankin Scale score of ≥3, was the main outcome. A moderate to severe stroke, determined by a National Institutes of Health Stroke Scale score of ≥6, was the secondary outcome.Six trials totaling 1,225 individuals were included in our analysis. In AIS patients, we discovered a significant correlation between lower LMR and poorer functional outcome at three months, with an OR of 0.63, 95% CI of 0.49 to 0.80, and a p-value of 0.0002. Additionally, lower LMR may be associated with developing moderate to severe stroke, with an OR of 0.89 (95% CI: 0.82-0.97; p = 0.008). In subgroup analyses with an LMR cutoff, a significant association was observed between lower LMR and greater functional impairment in AIS patients, with an odds ratio of 0.74 (95% CI: 0.62-0.88; p = 0.0005) for LMR ≥ 3 and 0.54 (95% CI: 0.47-0.61; p < 0.00001) for LMR < 3. Additionally, when country-stratified, Asian continued to have a significant correlation between worse functional outcome and lower LMR (OR 0.62, 95% CI: 0.50-0.77, p < 0.0001).This meta-analysis indicated that LMR was a prognostic factor for clinical outcomes in AIS patients.
Keywords: lymphocyte-to-monocyte, LMR, Acute ischemic stroke, AIS, Poor functional outcome, Stroke, prognosis
Received: 25 Feb 2025; Accepted: 23 Apr 2025.
Copyright: © 2025 Tian, Yang, Zhang, Wan, Wang, Zhou, Li, Guo and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yu Zhang, Affiliated Hospital and Clinical Medical College of Chengdu University, Chengdu, China
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