MHR and AIP independently predict 1-year MACCE in elderly stroke patients, and a combined MHR+AIP+baseline NIHSS model outperformed each individual marker, though endpoint-specific differences are exploratory and the combined model requires prospective validation.
MACCE occurred in 26.8% of elderly acute ischemic stroke patients within 1 year of follow-up.
MHR was an independent predictor of 1-year MACCE, with the strongest effect size of the three markers.
AIP was an independent predictor of 1-year MACCE.
Baseline NIHSS score was an independent predictor of 1-year MACCE.
In exploratory endpoint-specific analyses, MHR was associated with all three MACCE subtypes, whereas AIP was associated with stroke recurrence and coronary events but not all-cause mortality.
The combined model (MHR+AIP+baseline NIHSS) had the best discrimination, outperforming each individual marker.
The authors conclude that differences across endpoint subtypes are hypothesis-generating and that the combined model needs prospective validation.
This study looked at 429 older adults (65 or older) who had an ischemic stroke and followed them for one year. About 27% had a major cardiovascular or cerebrovascular event, such as another stroke, death, or a heart attack or angina. The researchers examined two blood-based markers, MHR (a ratio of monocytes, a type of white blood cell, to HDL or 'good' cholesterol) and AIP (an index of blood fats linked to artery disease), along with the stroke severity score at admission (NIHSS). All three measures independently predicted later events. MHR was the strongest single predictor and was linked to all types of events. AIP was linked to repeat stroke and heart events but not to death. These differences were exploratory, since the study was not large enough to confirm them statistically. Combining MHR, AIP and stroke severity gave better prediction (AUC 0.81) than any one measure alone (0.63 to 0.73). This research suggests that routine blood tests and an admission severity score could help identify older stroke patients at higher risk of later events. However, the study was retrospective and done at a single hospital, so the combined model needs to be tested in prospective studies before it can be used in practice.
Liang Z, Hu W, Xu C, Wang H, Li F. (2026). MHR and AIP as Differential Predictors of 1-Year Major Adverse Cardiovascular and Cerebrovascular Events After Acute Ischemic Stroke: A Combined Model Study.. Clinical interventions in aging. https://doi.org/10.2147/CIA.S622634