Abstract
Objectives: The monocyte to high-density lipoprotein ratio (MHR) has been considered to be a novel inflammatory marker of atherosclerotic cardiovascular disease. However, its role in the acute phase of acute isolated pontine infarctions remains elusive. We explored whether an association existed between elevated MHR levels and early neurological deterioration (END) in patients with isolated pontine infarction.Methods: Data from 212 patients with acute isolated pontine infarction were retrospectively analyzed. We examined the MHR in quartiles of increasing levels to evaluate for possible threshold effects. END was defined as an elevation in the total National Institutes of Health Stroke Scale (NIHSS) score ≥2 or an increase in NIHSS score ≥1 in motor power within the first week after symptom onset. Patients were divided into an END group and a non-END group. The association of MHR on END following pontine infarction was examined by logistic regression models after adjusting for age, NIHSS at admission, basilar artery stenosis, history of hypertension or hyperlipidemia or stroke, infarct size, fasting blood glucose, and paramedian pontine infarction.Results: The mean MHR was 0.44 ± 0.22. A total of 58 (27.36%) patients were diagnosed with END. END occurred within the first 48 h after hospitalization in 38 patients (65.52%). After adjusting for confounding and risk factors, the multivariate logistic regression analysis showed NIHSS at admission [odds ratio (OR), 1.228; 95% confidence interval (CI), 1.036–1.456], basilar artery stenosis (OR, 2.843; 95% CI, 1.205–6.727), and fasting blood glucose (OR, 1.296; 95% CI, 1.004–1.672) were independently associated with END. The odds ratio of END increased as the quartile level of MHR increased, with the lowest quartile used as the reference value. Compared to the first quartile of MHR, the third and fourth quartiles were associated with 4.847-fold (95% CI, 1.532–15.336) and 5.824-fold (95% CI, 1.845–18.385) higher odds of END in multivariate analysis.Conclusions: Elevated MHR levels may be valuable as a biomarker of END in patients with isolated pontine infarction. The elevated MHR was independently associated with END in isolated pontine infarction.
Highlights
Worsening neurological deficits, known as early neurological deterioration (END), occur in up to one-third of patients with acute ischemic stroke and have been shown to be associated with increased mortality and subsequent functional disabilities [1, 2]
A total of 212 patients with acute isolated pontine infarctions were included in the final analysis
The odds ratio for END increased with increasing quartile of monocyte to high-density lipoprotein ratio (MHR) with the lowest quartile used as the reference value
Summary
Known as early neurological deterioration (END), occur in up to one-third of patients with acute ischemic stroke and have been shown to be associated with increased mortality and subsequent functional disabilities [1, 2]. It has been reported to be related to the prediction of ischemic stroke from the general population [12] and carotid artery intima-media thickness in patients with type 2 diabetes [13]. In stroke-related studies, MHR has been reported to be a good predictive value of stroke-associated pneumonia [14] and mortality in patients with ischemic stroke [15]. There are no studies exploring the value of MHR in predicting END in patients with acute isolated pontine infarction. The aim of our study is to elucidate the association between MHR with END after acute isolated pontine infarction
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call