The Role of Monocyte to High-density Lipoprotein Cholesterol Ratio in Predicting the Severity of Acute Ischemic Stroke and its Association with the NIHSS.

BACKGROUND: Atherosclerosis, an underlying abnormality, plays a significant role in the progression of ischemic stroke. Inflammation, oxidative stress, platelet activation, endothelial dysfunction, and lipid abnormalities are the primary factors involved in the development of atherosclerosis. Monocytes, key contributors to chronic inflammation, actively participate in the development, progression, and rupture of atherosclerotic plaques within blood vessels. Therefore, the objective of this study is to investigate the monocyte to high-density lipoprotein cholesterol (HDL-C) ratio (MHR) in acute ischemic stroke (AIS) and its correlation with the National Institute of Health Stroke Scale (NIHSS) to predict the severity of the condition.

MATERIALS AND METHODS: A prospective observational study was conducted on 100 AIS patients and age/gender-matched controls at a hospital in Kota. Diagnostic methods included clinical examination, imaging, and laboratory tests. MHR was measured using a hematology analyzer and correlated with reference values and stroke severity.

RESULTS: The mean MHR of AIS patients were higher (14.12 ± 2.95) than controls (7.09 ± 1.48) (p = 0.0001). Besides, a statistically significant positive correlation was obtained between his MHR and NIHSS scores at admission and discharge. MHR values were significantly greater from a reference point in patients who deteriorated (18.48 ± 4.02) compared to significantly lower values in patients who improved (13.66 ± 2.44).

CONCLUSION: In our study, the MHR shows an increased value in patients with AIS, and a linear correlation is found with the NIHSS score. Thus, the method is a pocket-friendly, easily available, and simple-to-use novel inflammatory marker that may predict the severity of a disease.