Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 17:250:10517.
doi: 10.3389/ebm.2025.10517. eCollection 2025.

Correlation study of CAR, PLR, NLR with the prognosis of cardiogenic cerebral embolism patients

Xiaojing Du  1 , Xiaohui Li  1 , Sheng Yue  1 , Yuzhen Sun  1 , Mengzhen Zhao  1 , Lingshan Zhou  1 , Xingwei Wang  1 , Yapan Yang  2
Affiliations

Correlation study of CAR, PLR, NLR with the prognosis of cardiogenic cerebral embolism patients

Xiaojing Du et al. Exp Biol Med (Maywood). .

Abstract

This study explored the association between inflammatory biomarkers-C-reactive protein to albumin ratio (CAR), platelet to lymphocyte ratio (PLR), and neutrophil to lymphocyte ratio (NLR)-and the prognosis of patients with cardiogenic cerebral embolism (CCE). We retrospectively analyzed data from 80 CCE patients diagnosed between June 2020 and June 2024, categorizing them into favorable and unfavorable prognosis groups based on outcomes such as death, recurrence, and disability. The CAR, PLR, and NLR values were calculated from routine blood tests, and statistical analyses, including Spearman correlation, multivariate logistic regression, and ROC curve analysis, were performed to examine their prognostic significance. Results showed that the unfavorable prognosis group had significantly higher CAR, PLR, and NLR values compared to the favorable group (P < 0.05). Spearman correlation analysis revealed positive associations between these biomarkers and prognosis (r = 0.319 for CAR, 0.238 for PLR, 0.251 for NLR, all P < 0.05). Multivariate analysis identified CAR and NLR as independent risk factors for unfavorable prognosis (OR = 1.034 for CAR, OR = 3.887 for NLR). ROC analysis determined optimal cutoff values for CAR (>0.74), PLR (>160.00), and NLR (>3.53) to predict unfavorable prognosis with AUCs of 0.796, 0.694, and 0.705, respectively. The combined biomarker test yielded an AUC of 0.899. Kaplan-Meier survival analysis indicated significantly lower survival rates for patients with higher levels of CAR, PLR, and NLR (P < 0.05). In conclusion, elevated CAR, PLR, and NLR are reliable indicators of a poor prognosis in CCE patients.

Keywords: CAR; NLR; PLR; cardiogenic cerebral embolism; prognosis.

PubMed Disclaimer

Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

None
Cardiac cerebral embolism (CCE) is a serious cerebrovascular disease characterized by the detachment of blood clots from the heart. This study collected clinical data from 80 CCE patients for analysis and found that 18 cases experienced adverse prognostic events (including death, recurrence, or severe disability) within 6 months of follow-up, with an incidence rate of 22.5%. Through in-depth analysis, it was found that CAR, PLR, and NLR are closely related to the prognosis of CCE patients. Therefore, this study suggests that CAR, PLR, and NLR, as easily obtainable biomarkers of inflammatory response in routine clinical practice, combined detection can help identify high-risk CCE patients early and provide important basis for clinical decision-making.
FIGURE 1
FIGURE 1
Research technology roadmap.
FIGURE 2
FIGURE 2
ROC curve analysis affecting the prognosis of CCE patients. Note: NIHSS, national institutes of health stroke scale; CHF, Congestive heart failure; CAR, C-reactive protein to albumin ratio; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio. (A) The AUC of age, (B) The AUC of NIHSS, (C) The AUC of hypertension, (D) The AUC of CHF, (E) The AUC of CAR, (F) The AUC of PLR, (G) The AUC of NLR, (H) The AUC of CAR+PLR+NLR.
FIGURE 3
FIGURE 3
Kaplan-Meier survival curves of CCE patients with different CAR, PLR, and NLR levels. Note: CAR, C-reactive protein to albumin ratio; NLR, neutrophil-to-lymphocyte ratio; PLR, platelet-to-lymphocyte ratio. (A) The Kaplan-Meier of CAR, (B) The Kaplan-Meier of NLR, (C) The Kaplan-Meier of PLR.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Yu MY, Caprio FZ, Bernstein RA. Cardioembolic stroke. Neurol Clin (2024) 42(3):651–61. 10.1016/j.ncl.2024.03.002 - DOI - PubMed
    1. Celeste F, Muratori M, Mapelli M, Pepi M. The evolving role and use of echocardiography in the evaluation of cardiac source of embolism. J Cardiovasc Echography (2017) 27(2):33–44. 10.4103/jcecho.jcecho_1_17 - DOI - PMC - PubMed
    1. Collet J, Thiele H, Barbato E, Barthélémy O, Bauersachs J, Bhatt DL, et al. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J (2021) 42(14):1289–367. 10.1093/eurheartj/ehaa575 - DOI - PubMed
    1. Ortel TL, Neumann I, Ageno W, Beyth R, Clark NP, Cuker A, et al. American Society of Hematology 2020 guidelines for management of venous thromboembolism: treatment of deep vein thrombosis and pulmonary embolism. Blood Adv (2020) 4(19):4693–738. 10.1182/bloodadvances.2020001830 - DOI - PMC - PubMed
    1. Nomoto N, Tate S, Arai M, Iizaka S, Mori C, Sakurai K. Pretreatment nutritional status in combination with inflammation affects chemotherapy interruption in women with ovarian, fallopian tube, and peritoneal cancer. Nutrients. (2022) 14(23):5183. 10.3390/nu14235183 - DOI - PMC - PubMed

MeSH terms

LinkOut - more resources