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

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. 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. Significant baseline differences included hypertension, hyperlipidemia, atrial fibrillation, hsCRP, MHR, and hsCRP/HDL-C ratio (all p < 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 (p < 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, p = 0.047)] and were also associated with increased NIHSS scores at admission, day 3, and day 7 [quartile_4 (0 h: B = 2.92, p = 0.016; 3d: B = 3.30, p = 0.004; 7d: B = 3.91, p = 0.001)]. 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.