{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:21:44Z","timestamp":1787728904197,"version":"build-2784847793"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"vor","delay-in-days":236,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Stroke Research and Treatment"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the association between the monocyte\u2010to\u2010albumin ratio (MAR) and all\u2010cause mortality risk in stroke patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We analyzed data from 2022 stroke participants (aged \u2265 20 years) in the National Health and Nutrition Examination Survey (NHANES) 1999\u20132018. MAR was calculated as the monocyte count (\u00d710\n                      <jats:sup>9<\/jats:sup>\n                      \/L) divided by serum albumin (g\/L). The outcome was all\u2010cause mortality of stroke population. Multivariable Cox proportional hazards models were used to examine the association between MAR and all\u2010cause mortality, with restricted cubic splines assessing dose\u2013response relationships and Kaplan\u2013Meier curves with log\u2010rank tests evaluating cumulative survival probabilities. Furthermore, we compared the incremental predictive value of MAR against a conventional risk model (incorporating demographics and comorbidities) using the area under the curve (AUC), integrated discrimination improvement (IDI), and net reclassification improvement (NRI). Subgroup analyses and sensitivity analyses were performed, stratified by demographic and clinical characteristics, to verify robustness.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 2022 participants were included, of whom 1016 (50.2%) were male and 1506 (74.5%) were aged \u2265 60 years. In multivariable Cox regression adjusting for demographic, lifestyle, and clinical covariates, elevated MAR was independently associated with all\u2010cause mortality (per 1\u2010unit increase: HR = 1.35, 95% CI: 1.21\u20131.50; T3 vs. T1: HR = 1.32, 95% CI: 1.12\u20131.55; both\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Restricted cubic spline analysis revealed a nonlinear dose\u2013response relationship (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009for\u2009nonlinearity = 0.001). Kaplan\u2013Meier curves demonstrated lower survival probabilities in the highest MAR tertile (T3) compared to the lowest (T1) (log\u2010rank\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). With respect to model performance, incorporating MAR into the conventional risk model resulted in a statistically significant but modest improvement in discrimination (\n                      <jats:italic>\u0394<\/jats:italic>\n                      <jats:italic>A<\/jats:italic>\n                      <jats:italic>U<\/jats:italic>\n                      <jats:italic>C<\/jats:italic>\n                      = 0.0158) and reclassification accuracy (IDI = 0.0129, NRI = 0.208; all\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.05). Subgroup and sensitivity analyses confirmed the robustness of this association across various strata.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Elevated MAR is independently associated with long\u2010term mortality in stroke survivors, reflecting underlying inflammation and nutritional insufficiency. These findings support MAR\u2032s potential utility as a research tool in prospective cohort studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/srat\/5461096","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:46:13Z","timestamp":1787726773000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Monocyte\u2010to\u2010Albumin Ratio (MAR) Is Associated With All\u2010Cause Mortality in Adult Stroke Patients: Evidence From NHANES (1999\u20132018)"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9508-9552","authenticated-orcid":false,"given":"Jia","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0098-9341","authenticated-orcid":false,"given":"Yue","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2109-1442","authenticated-orcid":false,"given":"Jing","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,25]]},"reference":[{"key":"e_1_2_14_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.116.308413"},{"key":"e_1_2_14_2_2","doi-asserted-by":"publisher","DOI":"10.1586\/ern.11.99"},{"key":"e_1_2_14_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30506-2"},{"key":"e_1_2_14_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00281-022-00943-7"},{"key":"e_1_2_14_5_2","doi-asserted-by":"publisher","DOI":"10.1139\/apnm-2019-0865"},{"key":"e_1_2_14_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2025.1521099"},{"key":"e_1_2_14_7_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1504946"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S390557"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjno-2024-000718"},{"key":"e_1_2_14_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2025.1645793"},{"key":"e_1_2_14_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12883-024-03812-y"},{"key":"e_1_2_14_12_2","doi-asserted-by":"publisher","DOI":"10.18821\/0023-2149-2016-94-9-657-662"},{"key":"e_1_2_14_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2025.1705544"},{"key":"e_1_2_14_14_2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2025.1565979"},{"key":"e_1_2_14_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2025.1611289"},{"key":"e_1_2_14_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-94975-2"},{"key":"e_1_2_14_17_2","volume-title":"2017 MEC Laboratory Procedures Manual","author":"Centers for Disease Control and Prevention","year":"2017"},{"key":"e_1_2_14_18_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1338025"},{"key":"e_1_2_14_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s41043-024-00709-x"},{"key":"e_1_2_14_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-025-03001-8"},{"key":"e_1_2_14_21_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638280310001596487"},{"key":"e_1_2_14_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-65633-w"},{"key":"e_1_2_14_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-56744-5"},{"key":"e_1_2_14_24_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0306048"},{"key":"e_1_2_14_25_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0327180"},{"key":"e_1_2_14_26_2","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.1057587"},{"key":"e_1_2_14_27_2","doi-asserted-by":"publisher","DOI":"10.1289\/ehp.9466"},{"key":"e_1_2_14_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2018.11.076"},{"key":"e_1_2_14_29_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12963-025-00378-w"},{"key":"e_1_2_14_30_2","first-page":"1","article-title":"National Health and Nutrition Examination Survey: Analytic Guidelines, 1999-2010","volume":"161","author":"Johnson C. 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