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

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 MS 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.