Non-HDL/HDL Cholesterol Ratio as a Protective Factor for Functional Recovery Following Intracerebral Hemorrhage: A...

Area of Science:

• Neurology
• Cardiovascular Medicine
• Biochemistry

Background:

• Functional recovery after intracerebral hemorrhage (ICH) is crucial but influenced by various factors.
• The role of lipid profiles, specifically the non-high-density lipoprotein to high-density lipoprotein cholesterol ratio (NHHR), in ICH outcomes remains unclear.

Purpose of the Study:

• To investigate the association between the NHHR and 90-day functional outcomes in patients following an acute ICH.
• To determine if NHHR can serve as a predictive biomarker for functional recovery after ICH.

Main Methods:

• A prospective, observational cohort study involving 200 acute ICH patients.
• Fasting blood samples collected within 24 hours of admission for lipid profiling; NHHR calculated as (Total Cholesterol - HDL-C)/HDL-C.
• Functional outcome at 90 days assessed using the modified Rankin Scale (mRS), categorizing patients into favorable (mRS ≤ 2) and poor (mRS > 2) outcomes.

Main Results:

• 40.5% of patients experienced poor outcomes at 90 days.
• The poor outcome group had significantly lower baseline NHHR (2.54 vs. 2.75, P=0.002).
• Higher NHHR independently predicted reduced odds of poor outcome (aOR=0.608, P=0.019) and improved prognostic performance when combined with NIHSS (AUC=0.863).

Conclusions:

• Elevated baseline NHHR is an independent predictor of favorable 90-day functional outcomes post-ICH.
• NHHR represents a potential "protective lipid paradox" in ICH, distinct from findings in ischemic stroke.
• NHHR serves as a simple, accessible biomarker that complements existing clinical scales for early risk stratification in ICH patients.