High ratio of monocytes to high-density lipoprotein is associated with hemorrhagic transformation in acute ischemic stroke patients on intravenous thrombolysis

Xia, Lingfan; Tong, Xu; Zhan, Zhenxiang; Wu, Yucong; Xu, Ye; Cao, Yungang; Han, Zheng‐Fu

doi:10.3389/fnagi.2022.977332

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…Towards the same direction, Xia et al [ 54 ], questioned if patients with AIS receiving IVT would benefit from using the MHR as a predicting factor for HT. Consequently, they conducted a study to investigate whether IVT is associated with MHR and HT and in what manner.…”

Section: Discussionmentioning

confidence: 99%

Monocyte to HDL and Neutrophil to HDL Ratios as Potential Ischemic Stroke Prognostic Biomarkers

Gkantzios

Tsiptsios

Karapepera

et al. 2023

Neurology International

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Ischemic stroke (IS) exhibits significant heterogeneity in terms of etiology and pathophysiology. Several recent studies highlight the significance of inflammation in the onset and progression of IS. White blood cell subtypes, such as neutrophils and monocytes, participate in the inflammatory response in various ways. On the other hand, high-density lipoproteins (HDL) exhibit substantial anti-inflammatory and antioxidant actions. Consequently, novel inflammatory blood biomarkers have emerged, such as neutrophil to HDL ratio (NHR) and monocyte to HDL ratio (MHR). Literature research of two databases (MEDLINE and Scopus) was conducted to identify all relevant studies published between 1 January 2012 and 30 November 2022 dealing with NHR and MHR as biomarkers for IS prognosis. Only full-text articles published in the English language were included. Thirteen articles have been traced and are included in the present review. Our findings highlight the utility of NHR and MHR as novel stroke prognostic biomarkers, the widespread application, and the calculation of which, along with their inexpensive cost, make their clinical application extremely promising.

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Section: Discussionmentioning

confidence: 99%

Monocyte to HDL and Neutrophil to HDL Ratios as Potential Ischemic Stroke Prognostic Biomarkers

Gkantzios

Tsiptsios

Karapepera

et al. 2023

Neurology International

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“… 16 Recently, a meta‐analysis that involved 9 studies indicated that for patients with coronary heart disease, increased MHR value might be associated with higher long‐term mortality and major adverse cardiovascular events. 26 Nevertheless, some studies have explored the relationship between MHR and short‐term stroke prognosis based on small sample size data from one single center but reported inconsistent results for hemorrhagic transformation 27 , 28 and for all‐cause mortality. 20 , 22 The discrepancy might be due to the differences in the patients' characteristics, and the small sample size with limited statistical power.…”

Section: Discussionmentioning

confidence: 99%

Monocyte to high‐density lipoprotein ratio predicts clinical outcomes after acute ischemic stroke or transient ischemic attack

Chen

et al. 2023

CNS Neurosci Ther

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Aims The monocyte to high‐density lipoprotein cholesterol ratio (MHR) has emerged as a novel inflammatory biomarker of atherosclerotic cardiovascular disease. However, it has not yet been identified whether MHR can predict the long‐term prognosis of ischemic stroke. We aimed to investigate the associations of MHR levels with clinical outcomes in patients with ischemic stroke or transient ischemic attack (TIA) at 3 months and 1 year. Methods We derived data from the Third China National Stroke Registry (CNSR‐III). Enrolled patients were divided into four groups by quartiles of MHR. Multivariable Cox regression for all‐cause death and stroke recurrence and logistic regression for the poor functional outcome (modified Rankin Scale score 3–6) were used. Results Among 13,865 enrolled patients, the median MHR was 0.39 (interquartile range, 0.27–0.53). After adjustment for conventional confounding factors, the MHR level in quartile 4 was associated with an increased risk of all‐cause death (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.10–1.90), and poor functional outcome (odd ratio [OR], 1.47; 95% CI, 1.22–1.76), but not with stroke recurrence (HR, 1.02; 95% CI, 0.85–1.21) at 1 year follow‐up, compared with MHR level in quartile 1. Similar results were observed for outcomes at 3 months. The addition of MHR to a basic model including conventional factors improved predictive ability for all‐cause death and poor functional outcome validated by the C‐statistic and net reclassification index (all p < 0.05). Conclusions Elevated MHR can independently predict all‐cause death and poor functional outcome in patients with ischemic stroke or TIA.

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“…A high MHR is an independent predictor of 30-day mortality in ischemic stroke patients, 23 and a cohort study based on rural Chinese populations suggested a higher risk of ischemic stroke in groups with high levels of MHR. 24 Xia et al 25 analyzed 340 patients who underwent IVT and observed that the MHR was higher in patients with HT than in those without HT.…”

Section: Discussionmentioning

confidence: 99%

Low MHR Is Associated with Hemorrhagic Transformation in Acute Large Artery Atherosclerosis Ischemic Stroke Patients with Intravenous Thrombolysis

Meng

et al. 2023

Clin Appl Thromb Hemost

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Background: Hemorrhagic transformation (HT) is a common complication of intravenous thrombolysis (IVT) in patients with acute ischemic stroke (AIS) and may lead to neurological deterioration. This article discusses whether monocyte count to high-density lipoprotein ratio (MHR) level is associated with HT in AIS patients. Materials and methods: The clinical data of AIS patients who underwent rt-PA IVT treatment were continuously collected. According to whether HT occurred, patients were divided into HT group and non-HT group. Potential association between MHR and HT in different subtypes AIS was explored by using logistic regression. Results: A total of 444 AIS patients were retrospective analyzed. The MHR level was lower in HT group compared with the non-HT group in all AIS patients (0.28 vs 0.36, P = .031) and in large-artery atherosclerosis (LAA) type AIS patients (0.31 vs 0.37, P = .032). Low MHR was independently related to HT (OR:0.035, 95%CI:0.003−0.390, P = .006). Among all TOAST subtypes, low MHR was only independently associated with HT in patients of LAA-type AIS after adjusting for confounding factors (OR:0.01, 95%CI:0.00−0.62, P = .031), with an optimal cut-off value of 0.41, sensitivity of 85.7%, and specificity of 43.1%. MHR was not correlated with SVO, VE, and CE subtype AIS. Conclusion: Low MHR may be an independent predictor of HT in patients with AIS and this conclusion only existed in LAA-type AIS.

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High ratio of monocytes to high-density lipoprotein is associated with hemorrhagic transformation in acute ischemic stroke patients on intravenous thrombolysis

Cited by 5 publications

References 33 publications

Monocyte to HDL and Neutrophil to HDL Ratios as Potential Ischemic Stroke Prognostic Biomarkers

Monocyte to HDL and Neutrophil to HDL Ratios as Potential Ischemic Stroke Prognostic Biomarkers

Monocyte to high‐density lipoprotein ratio predicts clinical outcomes after acute ischemic stroke or transient ischemic attack

Low MHR Is Associated with Hemorrhagic Transformation in Acute Large Artery Atherosclerosis Ischemic Stroke Patients with Intravenous Thrombolysis

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