Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：CNS Neuroscience & Therapeutics

Publication type: Original Contributions

IF(IF): 5.5

PMID: 36914580 Link To Pubmed Full text Download

Atherosclerosis, especially intracranial atherosclerosis, is an intrinsic abnormality in the development of ischemic stroke. Inflammation and lipid abnormalities have been proposed as the main constituents of the pathophysiology of atherosclerosis development and progression. Monocytes, hallmarks of chronic inflammation, interact primarily with platelets and endothelial cells resulting in aggravation of inflammatory, pro-thrombotic pathways and are known to play an active role in the formation, progression and rupture of an atherosclerotic plaque at the vascular level. Conversely, the high-density lipoprotein cholesterol (HDL-C) counteracts these pro-inflammatory and prooxidant effects of monocytes by preventing the migration of macrophages and oxidation of LDL molecules and by promoting the efflux of cholesterol from these cells, thus inhibiting the inflammatory process and reducing the risk of atherosclerotic events. Monocyte-to-HDL-C ratio (MHR), which was calculated by dividing the absolute monocyte count by the absolute HDL-C count, has emerged as a novel inflammation marker and reported to be strongly associated with cardiovascular outcomes, including metabolic syndrome, coronary artery disease, atrial fibrillation recurrence, and ischemic stroke. Previous studies have shown that admission MHR values were independently correlated with increasing risk of disability or death in patients with intracerebral hemorrhage.Nevertheless, to our knowledge, few studies have investigated the association between MHR and short- and long-term prognosis in AIS. Therefore, this study aimed to investigate the associations of MHR and clinical outcomes among patients with ischemic stroke or transient ischemic attack based on CNSR-III.

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 poor functional outcome (modified Rankin Scale [mRS] score 3–6) were used.