Platelet to high-density lipoprotein cholesterol ratio predicts clinical outcomes after acute ischemic stroke: a prospective cohort study

 

Predicting failure to recover IS STUPIDER THAN HELL! Deliver recovery you blithering idiots!

Send me personal hate mail on this: oc1dean@gmail.com. I'll print your complete statement with your name and title(If you can't stand by your name don't bother replying anonymously) and my response in my blog. Or are you afraid to engage with my stroke-addled mind? No excuses are allowed! You're medically trained; it should be simple to precisely state EXACTLY WHERE I'M WRONG.

Exactly what in this research gets survivors recovered? 100% recovery is the only goal in stroke; NOT PREDICTIONS, BIOMARKERS, PROGNOSTICATION, OR ASSESSMENTS! I'd fire anyone doing these!

Platelet to high-density lipoprotein cholesterol ratio predicts clinical outcomes after acute ischemic stroke: a prospective cohort study

• 

  Xuan Sun 1†

• H

  Haochen Sun 2†

• Z

  Zhijia Tang 3

• 

  Xinyang Qi 2

• X

  Xian Wang 4

• X

  Xiaoyin Wang 2*

• 1. Department of Clinical Laboratory, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China

• 2. Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China

Abstract

Background: 

The platelet/high-density lipoprotein cholesterol ratio (PHR), a marker of hypercoagulable states and disordered lipid metabolism, has been confirmed as a predictor of cardiovascular disease. However, the effects of PHR on the prognosis of acute ischemic stroke (AIS) remain unknown. We aimed to assess the associations of PHR with the risk of clinical outcomes in patients with AIS.

Methods: 

This prospective observational study included 820 patients (median age, 68 years; female, 34.6%; median NIHSS at admission, 3) with AIS. The median time from symptom onset to admission was 2 days (interquartile range [IQR], 0–4), and from admission to blood sampling was 15 h (IQR, 12–19). PHR was calculated as platelet count (PC; 109 cells/L)/HDL-C (mmol/L) at admission. PHR was analyzed both as a continuous variable and in tertile form (tertile 1-tertile 3). To analyze the associations between PHR and clinical outcomes including all-cause death, stroke recurrence and poor functional outcome at 3 months, 6 months and 1 year, we used multivariable Cox and logistic regression, Kaplan–Meier survival curves, restricted cubic splines, subgroup analysis, concordance statistic (C-statistic), net reclassification index (NRI), and integrated discrimination improvement index (IDI).

Results: 

The median PHR was 202.155 (IQR, 153.120–262.365). Kaplan–Meier survival curves identified tertile 3 as the group with the highest risk for all-cause death and stroke recurrence. After adjustment, multivariable Cox regression (tertile 1 as reference) showed that the highest PHR tertile 3 was associated with increased risk for both all-cause death and stroke recurrence across all three follow-up intervals (3 months, 6 months and 1 year). In parallel, multivariable logistic regression (tertile 1 as reference) showed that tertile 3 was associated with a greater likelihood of poor functional outcome across the same three time points. Continuous PHR showed a positive dose–response relationship with clinical outcomes. Subgroup analysis revealed significant interactions of age (p < 0.05) with PHR for all-cause death, and of BMI (p < 0.05) with PHR for mRS 3–6. A basic model’s predictive ability was strengthened by the addition of PHR (C-statistic, NRI, IDI).

Conclusion: 

A higher PHR level in patients with AIS is strongly associated with an increased risk of all-cause death, stroke recurrence and poor functional outcome. As a valuable predictive biomarker, PHR may provide a simple and effective tool for predicting clinical outcomes in patients with AIS.

Graphical Abstract

Increased uric acid to high-density lipoprotein ratio positively correlated with stroke risk

 Your competent? doctor has been working on Uric acid a long time already, right? Oh no, you DON'T have a functioning stroke doctor, do you? And they still haven't been fired yet?

• Uric acid (11 posts to February 2014)

Increased uric acid to high-density lipoprotein ratio positively correlated with stroke risk

Tieshi Zhu^1†Yong He^2†Erxinxian Bei^1,3*

• ¹Department of Neurology, Zhanjiang Central Hospital, Guangdong Medical University, Zhanjiang, China
• ²Department of Neurology, Liuyang Jili Hospital, Changsha, China
• ³Department of Neurology, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China

Background: The Uric Acid-to-HDL Ratio (UHR), a novel index derived from serum uric acid and high-density lipoprotein, has been linked to hypertension and poor diabetes control. It has also been shown to predict ischemic heart disease and is strongly associated with collateral circulation and coronary artery flow reserve. However, fewer studies have focused on the relationship between UHR and stroke, highlighting the need for further research in this area.

Methods: The study included 33,192 individuals from the NHANES 1999–2023, of whom 1,363 had a history of stroke. The nonlinear relationship between UHR and stroke risk was assessed using restricted cubic spline (RCS) analysis, and the robustness of the findings was further tested through stratified analysis. Logistic regression was employed to analyze the relationship between UHR and stroke risk, considering both UHR as a continuous variable and its categorization into quartiles (Q1–Q4).

Results: UHR was not nonlinearly associated with stroke (p for overall <0.01; p for nonlinearity = 0.65), and the RCS graph approximated a straight line with a positive slope. UHR was significantly associated with an increased risk of stroke, both when analyzed as a continuous variable (Model 4: OR = 1.02, 95% CI 1.01–1.03, p < 0.01) and when categorized into quartiles (Q4, OR = 1.31, 95% CI 1.11–1.55, p < 0.01).

Conclusion: There was a significant positive correlation between UHR and stroke risk.

Introduction

Stroke remains a leading cause of mortality and disability worldwide, placing a substantial burden on individuals, families, and healthcare systems (1, 2). Given its unfavorable prognosis and the long-term functional impairments experienced by many survivors, a comprehensive understanding and identification of risk factors are essential for effective prevention strategies (3–5).

Traditional risk factors for stroke include hypertension, diabetes mellitus, dyslipidemia, smoking, and alcohol consumption (6–10). Beyond these established factors, elevated serum uric acid (UA) and reduced high-density lipoprotein (HDL) levels have also been implicated in stroke pathogenesis (11, 12). The Uric Acid-to-HDL Ratio (UHR) is a novel and easily accessible index that integrates these two parameters, providing a potential marker for systemic inflammatory and metabolic conditions (13, 14). Studies have demonstrated that UHR outperforms serum uric acid and HDL alone in predicting coronary artery disease and the severity of coronary stenosis (15). Furthermore, UHR has been associated with an increased risk of type 2 diabetes mellitus, metabolic syndrome, myocardial infarction, and all-cause mortality in individuals with diabetes (16–19). However, its relationship with stroke remains inadequately explored. Therefore, this study aims to investigate the association between UHR and stroke using data from the National Health and Nutrition Examination Survey (NHANES) 1999–2023, providing a foundation for future prospective research.

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