Monocyte/high-density lipoprotein ratio predicts the mortality in ischemic stroke patients

Objective: The inflammatory process is a very important stage in the development and prognosis of acute ischemic stroke (AIS). The monocyte to high-density lipoprotein (HDL) ratio (MHR) is accepted as a novel marker for demonstrating inflammation. However, the role of MHR as a predictor of mortality in patients with AIS remains unclear. Methods: We retrospectively enrolled 466 patients who were referred to our clinic within the first 24 hours of symptom presentation and who were diagnosed with AIS between January 2008 and June 2016. Four hundred and eight controls of similar age and gender were also included. The patient group was classified into two groups according to 30-day mortality. The groups were compared in terms of monocyte counts, HDL, and MHR values. Results: The patient group had significantly higher monocyte counts and lower HDL levels; therefore, this group had higher values of MHR compared to controls. Additionally, the monocyte count and MHR value were higher, and the HDL level was lower in non-surviving patients (p < 0.001). The MHR value was also observed as a significant independent variable of 30-day mortality in patients with AIS (p < 0.001). The optimum cut-off value of MHR in predicting the 30-day mortality for patients with AIS was 17.52 (95% CI 0.95-0.98). Conclusion: Our study demonstrated that a high MHR value is an independent predictor of 30-day mortality in patients with AIS. (c) 2017 Polish Neurological Society. Published by Elsevier Sp. z o.o. All rights reserved.