Study on the correlation between hsCRP/HDL-C ratio and the severity and prognosis of ischemic stroke.

Objective: Inflammatory and lipid biomarkers are increasingly recognized for their role in acute ischemic stroke (AIS). This study evaluated the predictive value of composite indicators, focusing on the hsCRP/HDL-C ratio.

Methods: A prospective study included 183 AIS patients and 194 controls from Sichuan Provincial People's Hospital (July 2023-July 2024). Venous blood samples assessed inflammatory and lipid markers. Primary outcome was 3-month functional prognosis (mRS 0-2 vs. 3-6); secondary outcomes included hemorrhagic transformation, NIHSS scores, and mortality.

Results: Significant baseline differences included hypertension, hyperlipidemia, atrial fibrillation, hsCRP, MHR, and hsCRP/HDL-C ratio (all  < 0.001). The hsCRP/HDL-C ratio showed high predictive accuracy (AUC analysis). Higher ratios correlated with atrial fibrillation, worse NIHSS scores, and poor 3-month prognosis ( < 0.001), but not hemorrhagic transformation or TOAST classification. After multivariate adjustment, higher quartiles of the hsCRP/HDL-C ratio remained an independent predictor of poor outcomes [quartile_4 (OR = 5.14, 95% CI: 1.03-25.81,  = 0.047)] and were also associated with increased NIHSS scores at admission, day 3, and day 7 [quartile_4 (0 h: B = 2.92,  = 0.016; 3d: B = 3.30,  = 0.004; 7d: B = 3.91,  = 0.001)].

Conclusion: The hsCRP/HDL-C ratio is strongly associated with AIS occurrence and predicts both short-term neurological deficits and long-term prognosis, offering clinical utility in risk stratification.