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Monocyte-to-High-Density Lipoprotein Ratio Predicts the Outcome of Acute Ischemic Stroke
Hongbing Liu1, Kai Liu1, Lulu Pei1
1Department of Neurology, the First Affiliated Hospital of Zhengzhou University.
Aim:
Monocyte-to-high-density lipoprotein ratio (MHR) recently emerged as an inflammatory marker and has been reported to be a novel prognostic indicator of cardiovascular diseases. However, the relationship between MHR and prognosis of acute ischemic stroke (AIS) remains unclear.
Methods:
Consecutive AIS patients were prospectively identified from January 2015 to December 2017. Functional outcome was evaluated by the modified Rankin Scale (mRS). Poor outcome was defined as of mRS 3-6. Multivariate logistic regression analysis was conducted to evaluate the relationship between MHR and poor outcome.
Results:
A total of 1090 AIS patients within 24 hours of the onset of symptoms were recruited. MHR was higher in poor outcome group compared to that in good outcome group [0.53 (0.37-0.69) vs. 0.48 (0.33-0.60), P=0.007]. Multivariate logistic regression analysis indicated that higher MHR level was independently associated with the poor outcome at 3 months (OR 2.58, 95% CI, 1.21-5.51, P=0.015), especially the stroke subtype of large artery atherosclerosis (OR 2.52, 95% CI, 1.03-6.19, P=0.034). Receiver operating curve (ROC) analysis showed that the area under the ROC curves for MHR was 0.67 and the best predictive cutoff value of MHR was 0.51,with a sensitivity of 62.3% and a specificity of 66.5%.
Conclusions:
MHR may be a significant and independent predictor of poor functional outcome in patients with AIS.
Insights
The monocyte-to-high-density lipoprotein ratio (MHR) may predict poor outcomes in acute ischemic stroke (AIS) patients. Higher MHR levels were independently associated with worse functional outcomes at three months post-stroke.
Area of Science:
- Cardiology
- Neurology
- Inflammation Markers
Background:
- The monocyte-to-high-density lipoprotein ratio (MHR) is an emerging inflammatory marker.
- MHR has shown prognostic value in cardiovascular diseases.
- The prognostic significance of MHR in acute ischemic stroke (AIS) is not well-established.
Purpose of the Study:
- To investigate the association between MHR and functional outcomes in patients with AIS.
- To determine if MHR can serve as an independent predictor of poor outcomes after AIS.
Main Methods:
- Prospective cohort study of 1090 AIS patients from January 2015 to December 2017.
- Functional outcome assessed using the modified Rankin Scale (mRS) at 3 months; poor outcome defined as mRS 3-6.
- Multivariate logistic regression and Receiver Operating Curve (ROC) analysis were employed.
Main Results:
- MHR was significantly higher in patients with poor outcomes compared to those with good outcomes (0.53 vs. 0.48, P=0.007).
- Elevated MHR was independently associated with poor functional outcome at 3 months (OR 2.58, P=0.015), particularly in large artery atherosclerosis stroke.
- The optimal MHR cutoff for predicting poor outcome was 0.51, with 62.3% sensitivity and 66.5% specificity (AUC=0.67).
Conclusions:
- MHR is a significant predictor of poor functional outcomes in AIS patients.
- MHR may serve as an independent prognostic marker for AIS prognosis.
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