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However, it has not yet been identified whether MHR can predict the long\u2010term prognosis of ischemic stroke. We aimed to investigate the associations of MHR levels with clinical outcomes in patients with ischemic stroke or transient ischemic attack (TIA) at 3\u00a0months and 1\u00a0year.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We derived data from the Third China National Stroke Registry (CNSR\u2010III). Enrolled patients were divided into four groups by quartiles of MHR. Multivariable Cox regression for all\u2010cause death and stroke recurrence and logistic regression for the poor functional outcome (modified Rankin Scale score 3\u20136) were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 13,865 enrolled patients, the median MHR was 0.39 (interquartile range, 0.27\u20130.53). After adjustment for conventional confounding factors, the MHR level in quartile 4 was associated with an increased risk of all\u2010cause death (hazard ratio [HR], 1.45; 95% confidence interval [CI], 1.10\u20131.90), and poor functional outcome (odd ratio [OR], 1.47; 95% CI, 1.22\u20131.76), but not with stroke recurrence (HR, 1.02; 95% CI, 0.85\u20131.21) at 1\u00a0year follow\u2010up, compared with MHR level in quartile 1. Similar results were observed for outcomes at 3\u00a0months. The addition of MHR to a basic model including conventional factors improved predictive ability for all\u2010cause death and poor functional outcome validated by the C\u2010statistic and net reclassification index (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Elevated MHR can independently predict all\u2010cause death and poor functional outcome in patients with ischemic stroke or TIA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.14152","type":"journal-article","created":{"date-parts":[[2023,3,14]],"date-time":"2023-03-14T03:41:14Z","timestamp":1678765274000},"page":"1953-1964","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Monocyte to high\u2010density lipoprotein ratio predicts clinical outcomes after acute ischemic stroke or transient ischemic attack"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8039-709X","authenticated-orcid":false,"given":"Qin","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"Beijing Municipal Key Laboratory of Clinical Epidemiology  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiong","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Neurology The Second Hospital of Dalian Medical University  Dalian China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, ZiBo Central Hospital  Zibo 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Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7396-1190","authenticated-orcid":false,"given":"Yijun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"Beijing Municipal Key Laboratory of Clinical Epidemiology  Beijing China"},{"name":"Department of Epidemiology and Health Statistics, School of Public Health Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"China 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China"},{"name":"Advanced Innovation Center for Human Brain Protection Capital Medical University  Beijing China"},{"name":"Center for Excellence in Brain Science and Intelligence Technology Chinese Academy of Sciences  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4918-0845","authenticated-orcid":false,"given":"Xia","family":"Meng","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anxin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital Capital Medical University  Beijing China"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing 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