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image of Prognostic Value of PHR and FHR for Outcomes in Acute Ischemic Stroke Patients with Large Artery Occlusion Undergoing Endovascular Treatment

Abstract

Introduction

Acute ischemic stroke (AIS) is linked to dysregulated immune-inflammatory responses. The platelet-to-high-density lipoprotein cholesterol ratio (PHR) and fibrinogen-to-high-density lipoprotein cholesterol ratio (FHR) have emerged as potential systemic inflammation biomarkers. This study evaluated the association among PHR, FHR, and 6-month functional outcomes in patients with large-vessel occlusion-related AIS (AIS-LVO) treated with endovascular therapy (EVT).

Methods

This single-center retrospective study included AIS-LVO patients undergoing EVT at Beijing Chaoyang Hospital (Jan 2023-May 2024). Demographic, clinical, and preoperative laboratory data were collected, and 6-month outcomes were assessed using the modified Rankin Scale (mRS). Multivariate logistic regression and operating characteristic curves (ROC) analyses were used to evaluate the predictive value of PHR and FHR, with subgroup analyses performed across clinical strata.

Results

A total of 46.76% (123/263) of patients had unfavorable outcomes at the 6-month follow-up. Multivariate analysis revealed that higher preoperative PHR (adjusted odds ratio [aOR] = 1.015; 95% confidence interval [CI], 1.009-1.020; < 0.001) and FHR (aOR = 1.007; 95% CI, 1.004-1.010; < 0.001) were independent risk factors for poor functional outcomes at 6 months post-EVT.

Discussion

Findings align with prior links between inflammatory biomarkers and AIS prognosis, extending to EVT-treated AIS-LVO. The utility of PHR/FHR may reflect integration of the prothrombotic-anti-inflammatory pathway, with limitations, including a single-center design and a lack of dynamic inflammatory monitoring.

Conclusion

PHR (PHR AUC=0.727, 95% CI: 0.667-0.788) and FHR (AUC=0.716, 95% CI: 0.655-0.777) independently predict 6-month outcomes, with elevated levels linked to poor prognosis. These markers may reflect synergistic roles in post-stroke inflammation and thrombosis, offering potential for integration into individualized prognostic models to guide early intervention.

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2025-12-30
2026-01-26

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Prognostic Value of PHR and FHR for Outcomes in Acute Ischemic Stroke Patients with Large Artery Occlusion Undergoing Endovascular Treatment
Bentham Science Publishers ; https://doi.org/10.2174/0115672026416428251201133449
/content/journals/cnr/10.2174/0115672026416428251201133449
/content/journals/cnr/10.2174/0115672026416428251201133449
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  • Article Type:     Research Article
Keywords: Large Vessel Occlusion (LVO) ; Endovascular Treatment (EVT) ; Acute Ischemic Stroke (AIS) ; Functional Outcome ; Fibrinogen-to-High-Density Lipoprotein Cholesterol Ratio (FHR) ; Platelet-to-High-Density Lipoprotein Cholesterol Ratio (PHR)

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