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

Abstract

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.

LCP1 knockdown in monocyte-derived macrophages: mitigating ischemic brain injury and shaping immune cell signaling and metabolism

“…Recruited from peripheral blood monocytes into the ischemic hemisphere, these cells differentiate into macrophages and play contrasting roles in the pathophysiology of ischemic stroke [19][20][21][22][23]. Proinflammatory macrophages contribute detrimentally to the acute phase, whereas anti-inflammatory macrophages aid in functional recovery in the later stages [14,[24][25][26][27]. Nevertheless, the associated pathophysiological mechanisms need further clarification.…”

Independent and joint associations of monocyte to high-density lipoprotein-cholesterol ratio and body mass index with cardiorenal syndrome: insights from NHANES 2003–2020

“…Previous epidemiological studies based on Chinese populations have explored various risk factors for adverse cardiovascular events, particularly acute ischemic stroke [ 11 , 24 ]. Additionally, a nationwide cohort study in the United States revealed the predictive value of MHR for long-term cardiovascular outcomes in the general population, and a follow-up study from Turkey also demonstrated the predictive capability of MHR for long-term outcomes in patients with acute coronary syndrome [ 14 , 25 ].…”

“…As a relatively new biomarker, the Monocyte to High-Density Lipoprotein-Cholesterol Ratio (MHR) combines two independent CVD risk factors, surpassing the predictive ability of monocyte count alone for CVD and reflecting the balance between chronic inflammation and oxidative stress [ 10 ]. Past epidemiological studies have extensively explored the association between elevated MHR and adverse cardiovascular events, demonstrating efficient predictive power for all-cause and cardiovascular mortality [ 11 – 14 ]. However, research on its correlation with CKD and CRS is quite limited.…”

Predictive value of monocyte-to-high-density lipoprotein-cholesterol ratio (MHR) for poor prognosis after intravenous thrombolytic therapy for acute ischaemic stroke

“…These findings hold substantial importance in devising strategies aimed at reducing MHR levels to prevent adverse cardiovascular outcomes. Furthermore, additional studies [35] have confirmed that elevated MHR levels independently forecasted an unfavourable prognosis and increased all-cause mortality among patients with ischaemic stroke or transient ischaemic attack (TIA). However, to date, to the best of my knowledge, no relationship has been found between MHR and outcomes in patients who did not receive treatment or who received endovascular therapy, pending the need for further research findings to be explored.…”