Objective:

To assess the associations of the platelet/high-density lipoprotein cholesterol ratio (PHR) with the risk of clinical outcomes in patients with acute ischemic stroke (AIS).

Approach:

• Study Design: A prospective observational study including 820 patients with AIS, analyzing PHR as a continuous variable and in tertiles.
• Data Analysis: Used multivariable Cox and logistic regression, Kaplan–Meier survival curves, and other statistical methods to evaluate associations between PHR and clinical outcomes.

Key Findings:

• The median PHR was 202.155 (IQR, 153.120–262.365).
• Tertile 3 of PHR was associated with the highest risk for all-cause death and stroke recurrence.
• Higher PHR levels correlated with increased likelihood of poor functional outcomes at 3 months, 6 months, and 1 year.
• Continuous PHR showed a positive dose–response relationship with clinical outcomes.

Interpretation:

A higher PHR level in patients with AIS is associated with an increased risk of all-cause death, stroke recurrence, and poor functional outcome.

Limitations:

• Single-center study may limit generalizability.
• Exclusion of patients without complete data may introduce selection bias.

Conclusion:

PHR may have potential as a predictive biomarker for clinical outcomes in patients with AIS.