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Study on the correlation between hsCRP/HDL-C ratio and the severity and prognosis of ischemic stroke
Ping Ni1,2, Haifeng Shao2, Qi Zhang1,2
1School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Insights
The high-sensitivity C-reactive protein to HDL-C ratio (hsCRP/HDL-C) effectively predicts acute ischemic stroke (AIS) risk and outcomes. This inflammatory and lipid biomarker composite indicator aids in stratifying patient prognosis and neurological deficits.
Area of Science:
- Cardiovascular Research
- Neurology
- Biomarker Discovery
Background:
- Inflammatory and lipid biomarkers are crucial in understanding acute ischemic stroke (AIS).
- Composite indicators, like the hsCRP/HDL-C ratio, offer novel insights into stroke pathophysiology.
- Previous research highlights the significance of individual markers, but composite analysis is evolving.
Purpose of the Study:
- To evaluate the predictive value of the hsCRP/HDL-C ratio in AIS.
- To assess the association of this ratio with short-term neurological deficits and long-term functional prognosis.
- To explore its utility in clinical risk stratification for AIS patients.
Main Methods:
- A prospective study involving 183 AIS patients and 194 controls.
- Assessment of inflammatory and lipid markers, including the hsCRP/HDL-C ratio, from venous blood samples.
- Analysis of 3-month functional prognosis (mRS), hemorrhagic transformation, NIHSS scores, and mortality.
Main Results:
- The hsCRP/HDL-C ratio was significantly higher in AIS patients (p < 0.001).
- Higher ratios correlated with atrial fibrillation, worse NIHSS scores, and poor 3-month prognosis (p < 0.001).
- The hsCRP/HDL-C ratio independently predicted poor outcomes (OR = 5.14) and was associated with increased NIHSS scores over time.
Conclusions:
- The hsCRP/HDL-C ratio is strongly linked to AIS occurrence.
- This ratio effectively predicts short-term neurological deficits and long-term prognosis.
- The hsCRP/HDL-C ratio demonstrates significant clinical utility in AIS risk stratification.
Objective:
Inflammatory and lipid biomarkers are increasingly recognized for their role in acute ischemic stroke (AIS). This study evaluated the predictive value of composite indicators, focusing on the hsCRP/HDL-C ratio.
Methods:
A prospective study included 183 AIS patients and 194 controls from Sichuan Provincial People's Hospital (July 2023-July 2024). Venous blood samples assessed inflammatory and lipid markers. Primary outcome was 3-month functional prognosis (mRS 0-2 vs. 3-6); secondary outcomes included hemorrhagic transformation, NIHSS scores, and mortality.
Results:
Significant baseline differences included hypertension, hyperlipidemia, atrial fibrillation, hsCRP, MHR, and hsCRP/HDL-C ratio (all p < 0.001). The hsCRP/HDL-C ratio showed high predictive accuracy (AUC analysis). Higher ratios correlated with atrial fibrillation, worse NIHSS scores, and poor 3-month prognosis (p < 0.001), but not hemorrhagic transformation or TOAST classification. After multivariate adjustment, higher quartiles of the hsCRP/HDL-C ratio remained an independent predictor of poor outcomes [quartile_4 (OR = 5.14, 95% CI: 1.03-25.81, p = 0.047)] and were also associated with increased NIHSS scores at admission, day 3, and day 7 [quartile_4 (0 h: B = 2.92, p = 0.016; 3d: B = 3.30, p = 0.004; 7d: B = 3.91, p = 0.001)].
Conclusion:
The hsCRP/HDL-C ratio is strongly associated with AIS occurrence and predicts both short-term neurological deficits and long-term prognosis, offering clinical utility in risk stratification.
