MHR and AIP as Differential Predictors of 1-Year Major Adverse Cardiovascular and Cerebrovascular Events After Acute Ischemic Stroke: A Combined Model Study.
- 1Department of Neurology, Lu'an People's Hospital, Lu'an, Anhui, People's Republic of China.
Abstract
Objective
To evaluate the predictive value of monocyte-to-high-density lipoprotein cholesterol ratio (MHR), plasma atherogenic index (AIP), and baseline National Institutes of Health Stroke Scale (NIHSS) score for 1-year major adverse cardiovascular and cerebrovascular events (MACCE) after acute ischemic stroke, and to explore potential differences in their predictive patterns across endpoint subtypes.Methods
This retrospective study enrolled 429 elderly patients (≥65 years) with acute ischemic stroke admitted to Lu'an People's Hospital (Anhui, China) between January 2020 and September 2023. Clinical and laboratory data were collected; MHR and AIP were Z-standardized. Patients were followed for 1 year for MACCE (stroke recurrence, all-cause mortality, non-fatal myocardial infarction/angina). Independent predictors were identified using multivariable logistic regression (Enter method: full model, then parsimonious model). Receiver operating characteristic (ROC) curves and DeLong tests compared individual and combined (MHR+AIP+baseline NIHSS) models. Endpoint-specific analyses were exploratory. Bootstrap resampling was performed for internal validation.Results
MACCE occurred in 115 patients (26.8%), comprising 58 stroke recurrences, 41 deaths, and 17 coronary events. MHR (per 1-SD increase: OR=2.765, 95% CI: 2.062-3.707, P<0.001), AIP (per 1-SD increase: OR=1.682, 95% CI: 1.289-2.193, P<0.001), and Baseline NIHSS score (OR=1.170, 95% CI: 1.108-1.235, P<0.001) were independent predictors of MACCE. In exploratory endpoint-specific analyses, MHR was associated with all three subtypes, while AIP was associated with stroke recurrence and coronary events but not all-cause mortality. However, formal interaction tests were underpowered. AUCs were 0.731 (MHR), 0.628 (AIP), 0.646 (NIHSS), and 0.810 (combined); the combined model outperformed all individual markers (all P<0.05 by DeLong test).Conclusion
MHR and AIP independently predict 1-year MACCE in elderly stroke patients. The observed differences in their associations across endpoint subtypes are exploratory and hypothesis-generating; formal interaction tests or adequately powered prospective studies are required. The combined model may improve risk stratification, but requires prospective validation.
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BibTeX
@article{liang2026differential,
title = {{MHR and AIP as Differential Predictors of 1-Year Major Adverse Cardiovascular and Cerebrovascular Events After Acute Ischemic Stroke: A Combined Model Study.}},
author = {Zhengling Liang and Wenxia Hu and Chitian Xu and Hui Wang and Feng Li},
journal = {Clinical interventions in aging},
year = {2026},
month = oct,
doi = {10.2147/cia.s622634},
url = {https://europepmc.org/article/MED/42974147},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - MHR and AIP as Differential Predictors of 1-Year Major Adverse Cardiovascular and Cerebrovascular Events After Acute Ischemic Stroke: A Combined Model Study.
AU - Zhengling Liang
AU - Wenxia Hu
AU - Chitian Xu
AU - Hui Wang
AU - Feng Li
PY - 2026
DA - 2026/10/29
JO - Clinical interventions in aging
DO - 10.2147/cia.s622634
UR - https://europepmc.org/article/MED/42974147
AB - Objective To evaluate the predictive value of monocyte-to-high-density lipoprotein cholesterol ratio (MHR), plasma atherogenic index (AIP), and baseline National Institutes of Health Stroke Scale (NIHSS) score for 1-year major adverse cardiovascular and cerebrovascular events (MACCE) after acute ischemic stroke, and to explore potential differences in their predictive patterns across endpoint subtypes.Methods This retrospective study enrolled 429 elderly patients (≥65 years) with acute ischemic stroke admitted to Lu'an People's Hospital (Anhui, China) between January 2020 and September 2023. Clinical and laboratory data were collected; MHR and AIP were Z-standardized. Patients were followed for 1 year for MACCE (stroke recurrence, all-cause mortality, non-fatal myocardial infarction/angina). Independent predictors were identified using multivariable logistic regression (Enter method: full model, then parsimonious model). Receiver operating characteristic (ROC) curves and DeLong tests compared individual and combined (MHR+AIP+baseline NIHSS) models. Endpoint-specific analyses were exploratory. Bootstrap resampling was performed for internal validation.Results MACCE occurred in 115 patients (26.8%), comprising 58 stroke recurrences, 41 deaths, and 17 coronary events. MHR (per 1-SD increase: OR=2.765, 95% CI: 2.062-3.707, P<0.001), AIP (per 1-SD increase: OR=1.682, 95% CI: 1.289-2.193, P<0.001), and Baseline NIHSS score (OR=1.170, 95% CI: 1.108-1.235, P<0.001) were independent predictors of MACCE. In exploratory endpoint-specific analyses, MHR was associated with all three subtypes, while AIP was associated with stroke recurrence and coronary events but not all-cause mortality. However, formal interaction tests were underpowered. AUCs were 0.731 (MHR), 0.628 (AIP), 0.646 (NIHSS), and 0.810 (combined); the combined model outperformed all individual markers (all P<0.05 by DeLong test).Conclusion MHR and AIP independently predict 1-year MACCE in elderly stroke patients. The observed differences in their associations across endpoint subtypes are exploratory and hypothesis-generating; formal interaction tests or adequately powered prospective studies are required. The combined model may improve risk stratification, but requires prospective validation.
SN - 1176-9092
SN - 1178-1998
ER -