The association between monocyte to high-density lipoprotein ratio and hemorrhagic transformation in patients with acute ischemic stroke

Wang, Yanan; Cheng, Yajun; Song, Quhong; Wei, Chuanliang; Liu, Junfeng; Wu, Bo; Liu, Ming

doi:10.18632/aging.102757

Cited by 25 publications

(21 citation statements)

References 37 publications

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“…At the same time, HDL can recruit new endothelial cells to injured vascular endothelium, thereby promoting its repair (Riwanto et al, 2015). Contrary to our findings, another study associated higher MHR with lower risk of HT in patients with ischemic stroke (Wang et al, 2020). It is possible that this discrepancy reflects the different functions of different monocyte subpopulations in the two studies.…”

Section: Discussioncontrasting

confidence: 99%

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

Xia

Tong

Zhan

et al. 2022

Front. Aging Neurosci.

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BackgroundHemorrhagic transformation (HT) is a frequent, serious complication in acute ischemic stroke patients on intravenous thrombolysis. Here we investigated whether risk of HT is associated with the ratio of monocyte count to high-density lipoprotein level (MHR).Materials and methodsMedical records were retrospectively examined for consecutive patients with acute ischemic stroke who received thrombolytic therapy. HT was diagnosed by computed tomography at 24–36 h after therapy. Potential association between MHR and HT was examined using logistic regression.ResultsA total of 340 patients were analyzed, and their median MHR was 0.44 (0.31–0.59). MHR was higher in the 51 patients (15.0%) with HT than in those who did not suffer HT (0.53 vs. 0.42, P = 0.001). Multivariate logistic regression showed that, after adjusting for potential confounders, MHR was an independent risk factor for HT (OR 7.50, 95% CI 1.64 to 34.35, P = 0.009). Risk of HT was significantly higher among patients whose MHR fell in the third quartile (0.42–0.53) and the fourth quartile (> 0.53) than among those with MHR in the first quartile (< 0.31; OR 3.53, 95% CI 1.11 to 11.20, P = 0.032; OR 4.79, 95% CI 1.49 to 15.42, P = 0.009).ConclusionHigh MHR may be independently associated with higher risk of HT in patients with acute ischemic stroke on intravenous thrombolysis.

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Section: Discussioncontrasting

confidence: 99%

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

Xia

Tong

Zhan

et al. 2022

Front. Aging Neurosci.

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“…Elevated MHR has also been found to be associated with a higher risk of HT in those patients undergoing MT ( 47 ). But another study showed that elevated MHR was associated with a lower risk of HT in ischemic stroke patients ( 22 ). In addition, a study on MHR and prognosis of acute ischemic stroke showed that non-surviving patients had higher MHR levels, and a high MHR value was an independent risk factor for 30-day mortality in patients with acute ischemic stroke ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

“…Recently, a study found that high MHR level was related to the poor functional prognosis of patients with acute ischemic stroke, especially the stroke subtype of LAA (21). Other studies based on patients with ischemic stroke showed that elevated MHR level was associated with high mortality but a low risk of hemorrhagic transformation (22,23). Indeed, there are few studies on the correlation between MHR and ischemic stroke, especially LAA ischemic stroke.…”

Section: Introductionmentioning

confidence: 99%

Monocyte/High-Density Lipoprotein Ratio Predicts the Prognosis of Large Artery Atherosclerosis Ischemic Stroke

Chen

Sun

et al. 2021

Front. Neurol.

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Objective: Monocyte to high-density lipoprotein ratio is considered as a new inflammatory marker and has been used to predict the severity of coronary heart disease and the incidence of adverse cardiovascular events (ACEs). However, there is a lack of data relative to large artery atherosclerosis (LAA) ischemic stroke. We investigated whether the monocyte to high-density lipoprotein (HDL) ratio (MHR) is related to the 3-month functional prognosis of LAA ischemic stroke.Materials and Methods: A retrospective analysis was conducted on 316 LAA ischemic stroke patients. The 3-month functional outcome was divided into good and poor according to the modified Rankin Scale (mRS) score. Multivariate logistic regression analysis was performed to evaluate the correlation between MHR and prognosis of ischemic stroke.Results: The MHR level of poor functional outcome group was higher than that of the good functional outcome group [0.44 (0.3, 0.55) vs. 0.38 (0.27, 0.5), P = 0.025]. Logistic stepwise multiple regression revealed that MHR [odds ratio (OR) 9.464, 95%CI 2.257–39.678, P = 0.002] was an independent risk factor for the 3-month poor outcome of LAA ischemic stroke. Compared to the lower MHR tertile, the upper MHR tertile had a 3.03-fold increase (95% CI 1.475–6.225, P = 0.003) in the odds of poor functional outcome after adjustment for potential confounders. Moreover, a multivariable-adjusted restricted cubic spline (RCS) showed a positive close to a linear pattern of this association.Conclusion: Elevated MHR was independently associated with an increased risk of poor 3-month functional outcome of patients with LAA ischemic stroke.

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“…Because monocyte counts did not change during AIS, the counts cannot predict long-term mortality ( 79 , 80 ). A recent investigation demonstrated that lower MHRs were independently associated with increased HT risk, especially sICH in AIS patients ( 81 ). The possible explanation for these paradoxical results may be the functional heterogeneity.…”

Section: Role Of Peripheral Immune Cells In the Disruption Of Bbb In Strokementioning

confidence: 99%

Immune Cells in the BBB Disruption After Acute Ischemic Stroke: Targets for Immune Therapy?

et al. 2021

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Blood-Brain Barrier (BBB) disruption is an important pathophysiological process of acute ischemic stroke (AIS), resulting in devastating malignant brain edema and hemorrhagic transformation. The rapid activation of immune cells plays a critical role in BBB disruption after ischemic stroke. Infiltrating blood-borne immune cells (neutrophils, monocytes, and T lymphocytes) increase BBB permeability, as they cause microvascular disorder and secrete inflammation-associated molecules. In contrast, they promote BBB repair and angiogenesis in the latter phase of ischemic stroke. The profound immunological effects of cerebral immune cells (microglia, astrocytes, and pericytes) on BBB disruption have been underestimated in ischemic stroke. Post-stroke microglia and astrocytes can adopt both an M1/A1 or M2/A2 phenotype, which influence BBB integrity differently. However, whether pericytes acquire microglia phenotype and exert immunological effects on the BBB remains controversial. Thus, better understanding the inflammatory mechanism underlying BBB disruption can lead to the identification of more promising biological targets to develop treatments that minimize the onset of life-threatening complications and to improve existing treatments in patients. However, early attempts to inhibit the infiltration of circulating immune cells into the brain by blocking adhesion molecules, that were successful in experimental stroke failed in clinical trials. Therefore, new immunoregulatory therapeutic strategies for acute ischemic stroke are desperately warranted. Herein, we highlight the role of circulating and cerebral immune cells in BBB disruption and the crosstalk between them following acute ischemic stroke. Using a robust theoretical background, we discuss potential and effective immunotherapeutic targets to regulate BBB permeability after acute ischemic stroke.

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The association between monocyte to high-density lipoprotein ratio and hemorrhagic transformation in patients with acute ischemic stroke

Cited by 25 publications

References 37 publications

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

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

Monocyte/High-Density Lipoprotein Ratio Predicts the Prognosis of Large Artery Atherosclerosis Ischemic Stroke

Immune Cells in the BBB Disruption After Acute Ischemic Stroke: Targets for Immune Therapy?

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