Abstract
BackgroundThis study aims to investigate the role of the total cholesterol to high-density lipoprotein cholesterol ratio (THR) in predicting carotid stenosis in patients with acute ischemic stroke (AIS), aiming to establish its clinical utility in risk assessment and therapeutic decision-making.Methods180 patients with AIS and concomitant carotid stenosis were classified into three groups (classified as mild [<50%], moderate [50-70%], or severe [≥70%]) based on stenosis severity. These groups were compared to 180 healthy controls. Carotid stenosis was diagnosed in all participants using digital subtraction angiography, with the severity graded accordingly. THR and lipid profiles were analyzed within 24 h of admission. Statistical analyses included ANOVA, ROC curve evaluation, and multivariate regression to determine THR's predictive performance for stenosis severity.ResultsTHR levels were significantly elevated in AIS patients versus controls (3.80 ± 1.07 vs 3.02 ± 0.67; p < 0.05) and correlated with stenosis severity (mild: 3.22 ± 0.85; moderate:3.86 ± 0.91; severe: 4.33 ± 1.16; p < 0.05). ROC analysis demonstrated robust diagnostic accuracy (AUC: 0.807; 95% CI: 0.744-0.870), with a cutoff of 4.15 yielding 81.1% sensitivity and 95.6% specificity for severe stenosis.ConclusionsTHR is a cost-effective, independent biomarker for carotid stenosis severity in AIS; its clinical use improves risk stratification and guides personalized care.