Association between the atherogenic index of plasma and the non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio with early neurological deterioration after thrombolysis.

BACKGROUND

The atherogenic index of plasma (AIP) and non-high-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio (NHHR) are newly developed markers of lipid and glucose metabolism. Nevertheless, the associations between the AIP or NHHR and early neurological deterioration (END) following thrombolysis in patients with acute ischemic stroke (AIS) remain ambiguous.

METHODS

1,323 AIS patients who had intravenous thrombolysis between January 2018 and October 2024 were retrospectively analyzed. An increase in the National Institutes of Health Stroke Scale (NIHSS) score of > 4 within 24 h following thrombolysis was considered post-thrombolysis END. Logistic regression analysis was conducted to investigate the associations between the AIP and NHHR with post-thrombolysis END. Receiver operating characteristic (ROC) analysis was employed to evaluate the AIP and NHHR capacity to differentiate post-thrombolysis END.

RESULTS

Of the 1,323 patients who were recruited, 1,125 (85.03%) had non-END and 198 (14.97%) had post-thrombolysis END. A binary logistic regression model demonstrated that the AIP [odds ratio (OR), 1.657; 95% confidence interval (CI) 1.441-1.875,  < 0.001] and NHHR (OR, 1.519; 95% CI, 1.342-1.812,  < 0.001) were independent factors for post-thrombolysis END. The area under the curve (AUC) values for the AIP, NHHR, and AIP combined with the NHHR for post-thrombolysis END were 0.753, 0.678, and 0.795, respectively.

CONCLUSION

Our study suggests that the AIP and NHHR could be used as prognostic indicators to predict post-thrombolysis END.