Higher hs-CRP to HDL-C ratio associated with adverse outcomes in ischaemic stroke patients, finds study

A new study published in the journal of BMC Neurology showed that an elevated high-sensitivity C-reactive protein (hs-CRP) to high-density lipoprotein cholesterol (HDL-C) ratio (hs-CRP/HDL-C ratio) considerably raised the risk of bad outcomes in individuals who had an acute ischemic stroke (AIS), where each unit increase was associated with a 2.4% higher chance of adverse outcomes.

According to recent Global Burden of Disease (GBD) data, stroke mortality, incidence, and disability-adjusted life years (DALYs) decreased between 1999 and 202. It is currently unknown if blood high-sensitivity C-reactive protein (hs-CRP) to high-density lipoprotein cholesterol (HDL-C) ratios are associated with outcomes in individuals with acute ischemic stroke. 

Data from a prospective cohort study including 1559 AIS patients who were enrolled at a South Korean hospital between January 2010 and December 2016 were used in this secondary analysis. To investigate the relationship between the hs-CRP/HDL-C ratio and adverse outcomes in AIS patients, this study built a binary logistic regression model. To clarify possible nonlinear interactions, a generalized additive model (GAM) with smooth curve fitting was attempted. Also, binary logistic regression models were created for either side of the inflection points, which were found using a recursive technique. The best model for elucidating the relationship between the hs-CRP/HDL-C ratio and adverse outcomes in patients with AIS was ultimately determined using a log-likelihood ratio test.

The outcomes suggested that the median hs-CRP/HDL-C ratio was 3.64, and the incidence of adverse events was 24.5%. A statistically significant positive correlation between the hs-CRP/HDL-C ratio and the probability of poor outcomes in AIS patients was found using the binary logistic regression model after controlling for other variables. With the hs-CRP/HDL-C ratio's initial inflection point at 42.74, a nonlinear connection was noted. A 2.4% higher chance of adverse outcomes was linked to every unit rise in the hs-CRP/HDL-C ratio.

Overall, the hs-CRP/HDL-C ratio and 3-month adverse outcomes in AIS patients were shown to be positively and nonlinearly correlated in this study. A substantial positive correlation between rising ratios and worse outcomes in AIS patients was identified when the hs-CRP/HDL-C ratio was ≤42.74. Thus, the hs-CRP/HDL-C ratio may be a practical and affordable predictive biomarker that predicts negative results in AIS patients.

Source:

Luwen, H., Lei, X., Qing-Rong, O., Linlin, L., & Ming, Y. (2024). Association between hs-CRP/HDL-C ratio and three-month unfavorable outcomes in patients with acute ischemic stroke: a second analysis based on a prospective cohort study. In BMC Neurology (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12883-024-03929-0