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MPO-to-albumin ratio at admission predicts 90-day stroke recurrence
Xiangqi Kong1, Haobo Wang1, Penghong Li1
1Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan 030032,China.
Background:
Globally, acute ischemic stroke (AIS) remains a leading cause of mortality, and recurrence further worsens long-term outcomes. Oxidative-inflammatory imbalance plays a crucial role in stroke recurrence. Myeloperoxidase (MPO) is a key pro-oxidant enzyme, while albumin (Alb) is the predominant antioxidant protein. Integrating both parameters, the MPO-to-albumin ratio (MPO/Alb) may better capture this imbalance. This study examined the relationship between MPO/Alb and 90-day stroke recurrence.
Methods:
In this retrospective cohort, 422 AIS patients admitted to Shanxi Bethune Hospital (October 2022-September 2023) were enrolled. Baseline clinical and laboratory data were collected, and MPO/Alb ratio was calculated. The primary outcome was 90-day recurrence, assessed via telephone follow-up. Multivariable logistic regression, quartile trend tests, restricted cubic spline (RCS) modeling and subgroup analyses were conducted.
Results:
Of 422 patients, 23 experienced recurrence within 90 days. Compared with the non-recurrence group, recurrent cases had significantly higher MPO and MPO/Alb levels (p < 0.05). Fully adjusted regression indicated that every unit increase in MPO/Alb predicted a 21 % greater recurrence risk (OR = 1.21). Quartile analysis indicated a dose-response relationship, with the highest quartile exhibiting a nearly 10-fold elevated risk (OR = 9.93). RCS analysis confirmed a linear association. No significant interactions were detected across the predefined subgroups.
Conclusion:
Elevated MPO/Alb ratio at admission independently predicts 90-day recurrence in AIS. As a simple and inexpensive biomarker, it may aid early risk stratification and secondary prevention, pending validation in multicenter prospective studies.
Insights
The MPO/Alb ratio, measuring oxidative-inflammatory imbalance, predicts 90-day acute ischemic stroke recurrence. Higher ratios indicate increased risk, aiding early stroke prevention strategies.
Area of Science:
- Neurology
- Biochemistry
- Cardiovascular Medicine
Background:
- Acute ischemic stroke (AIS) is a leading cause of death and disability globally.
- Stroke recurrence significantly worsens patient outcomes.
- Oxidative-inflammatory imbalance, involving myeloperoxidase (MPO) and albumin (Alb), is implicated in AIS recurrence.
Purpose of the Study:
- To investigate the association between the MPO-to-albumin ratio (MPO/Alb) and 90-day stroke recurrence in AIS patients.
- To evaluate MPO/Alb as a potential biomarker for predicting AIS recurrence.
Main Methods:
- Retrospective cohort study of 422 AIS patients.
- Collection of baseline clinical and laboratory data, including MPO/Alb ratio calculation.
- Assessment of 90-day stroke recurrence via follow-up, analyzed using multivariable logistic regression, quartile trends, and restricted cubic spline (RCS) modeling.
Main Results:
- 23 out of 422 patients experienced 90-day recurrence.
- Patients with recurrence had significantly higher MPO and MPO/Alb levels.
- Elevated MPO/Alb independently predicted increased recurrence risk (OR=1.21 per unit increase), showing a dose-response relationship and linear association.
Conclusions:
- The MPO/Alb ratio is an independent predictor of 90-day recurrence in AIS.
- This simple, inexpensive biomarker may assist in early risk stratification for secondary stroke prevention.
- Further validation in multicenter prospective studies is warranted.
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