Predictive value of systemic immune-inflammation index and neutrophil to high-density lipoprotein ratio in acute ischemic stroke


Meng L., Feng A., Ding Z.

INTERNATIONAL JOURNAL OF NEUROSCIENCE, 2025 (SCI-Expanded, Scopus) identifier identifier identifier

Abstract

Objective To investigate the predictive value of the Systemic Immune-Inflammation Index (SII) and the neutrophil to high-density lipoprotein cholesterol ratio (NHR) for adverse cardiovascular and cerebrovascular events in patients with acute stroke. Methods A retrospective analysis was conducted on 260 acute stroke patients. Based on the occurrence of adverse events, patients were divided into a no-event group (Group A, n = 195) and an event group (Group B, n = 65). Risk factors were identified using logistic regression, and the predictive performance of SII and NHR was assessed by receiver operating characteristic (ROC) curve analysis. Results Compared with Group B, Group A had a higher proportion of male patients, older age, smoking history, and elevated levels of white blood cell count, neutrophil percentage, lymphocyte percentage, platelet count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and SII (p < 0.05). Univariate and multivariate logistic regression analyses demonstrated that, after adjusting for confounding factors such as sex and age, SII and NHR were independent risk factors for postoperative adverse cardiovascular events in acute stroke patients. ROC curve analysis revealed that the area under the curve (AUC) values for SII, NHR, and their combined detection in predicting adverse cardiovascular events were 0.729, 0.626, and 0.916, respectively, with significant differences (p < 0.05). Conclusion SII and NHR are independent predictors of recurrent cardiovascular and cerebrovascular events in acute stroke patients. Combined detection of SII and NHR offers superior predictive performance.