Monocyte-to-High-Density Lipoprotein Ratio Predicts the Outcome of Acute Ischemic Stroke

Abstract

Aim: Monocyte-to-high-density lipoprotein ratio (MHR) recently emerged as an inflammatory marker and has been reported to be a novel prognostic indicator of cardiovascular diseases. However, the relationship between MHR and prognosis of acute ischemic stroke (AIS) remains unclear. Methods: Consecutive AIS patients were prospectively identified from January 2015 to December 2017. Functional outcome was evaluated by the modified Rankin Scale (mRS). Poor outcome was defined as of mRS 3–6. Multivariate logistic regression analysis was conducted to evaluate the relationship between MHR and poor outcome. Results: A total of 1090 AIS patients within 24 hours of the onset of symptoms were recruited. MHR was higher in poor outcome group compared to that in good outcome group [0.53 (0.37–0.69) vs. 0.48 (0.33–0.60), P = 0.007]. Multivariate logistic regression analysis indicated that higher MHR level was independently associated with the poor outcome at 3 months (OR 2.58, 95% CI, 1.21–5.51, P = 0.015), especially the stroke subtype of large artery atherosclerosis (OR 2.52, 95% CI, 1.03–6.19, P = 0.034). Receiver operating curve (ROC) analysis showed that the area under the ROC curves for MHR was 0.67 and the best predictive cutoff value of MHR was 0.51, with a sensitivity of 62.3% and a specificity of 66.5%. Conclusions: MHR may be a significant and independent predictor of poor functional outcome in patients with AIS.

Monocyte Transmodulation: The Next Novel Therapeutic Approach in Overcoming Ischemic Stroke?

“…In addition, research on newly identified prognostic biomarkers related to monocytes in AIS has gained interest. Recently, Liu et al reported that a higher monocyte-to-highdensity lipoprotein ratio (MHR) is highly associated with the risk of poor functional outcomes within 3 months in patients with AIS, thereby suggesting MHR as a novel marker to evaluate ischemic stroke prognosis, widening the treatment window from mere hours to months (130). Wang et al demonstrated the correlation between macrophage migration inhibitory factor (MIF) serum levels and ischemic stroke, stating that high MIF levels are directly related to moderate or severe ischemic stroke outcomes (131).…”

Atherogenic Index of Plasma Predicts Outcomes in Acute Ischemic Stroke

“…Patients enrolled in the study were from the database of the Henan Province Stroke Registry ( 14 – 16 ) at the First Affiliated Hospital of Zhengzhou University from January 2015 to December 2018. AIS was diagnosed according to criteria defined by the World Health Organization ( 17 ) based on neuroimaging results, patient history, and clinical data.…”

“…AIS was diagnosed according to criteria defined by the World Health Organization ( 17 ) based on neuroimaging results, patient history, and clinical data. All patients signed written informed consent, and this study was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University ( 14 ).…”

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

“…Because increased numbers of circulating monocytes were associated with HARM, larger AIS volume, worsened NIHSS score, and poorer outcomes compared to lower numbers of circulating monocytes ( 75 ). Higher monocyte-to-HDL (high-density lipoprotein) ratios (MHR) and monocyte-to-lymphocyte ratios (MLR) were associated with higher HT risk and poorer outcomes compared to lower ratios ( 76 , 77 ). Monocytes were found to be accumulated and randomly distributed in erythrocytic thrombi, engendering a higher NIHSS score ( 78 ).…”