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Background <p>Monoclonal gammopathy of undetermined significance (MGUS) has been associated with thromboembolic and cardiovascular complications; however, its prognostic significance in patients with cerebral infarction (CI) remains unclear. This study investigated the association between MGUS and long-term outcomes in CI and evaluated the predictive value of MGUS for CI prognosis.</p> Methods <p>In this retrospective propensity score-matched cohort study, 60 CI patients with MGUS and 360 matched CI patients without MGUS were enrolled from Zhongshan Hospital. Patients were followed for a median of 5.8&#xa0;years, with all-cause mortality as the primary endpoint. Kaplan–Meier survival analysis and Cox proportional hazards models were applied to assess prognostic associations. A prognostic nomogram was developed in a training cohort and validated in an independent test cohort.</p> Results <p>Patients with CI and concomitant MGUS exhibited significantly higher all-cause mortality compared with those without MGUS (log-rank <i>p</i> = 0.017). After adjustment for confounding variables, MGUS remained independently associated with increased mortality risk (hazard ratio 2.47; 95% CI 1.25–4.90; <i>p</i> = 0.009). A nomogram incorporating MGUS, age, modified Rankin Scale score, and D-dimer demonstrated strong discrimination, with C-indices of 0.837 in the training set and 0.792 in the validation set.</p> Conclusion <p>MGUS is independently associated with poor long-term prognosis in patients with cerebral infarction. Incorporation of MGUS into prognostic assessment improves risk stratification and may inform individualized management strategies for CI patients.</p>

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Monoclonal gammopathy of undetermined significance predicts long-term mortality after cerebral infarction: a propensity-matched cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月27日

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  • Guanru Niu,
  • Zhen Zhang,
  • Yuchen Liu,
  • Yijun Shen,
  • Ming Wang,
  • Yan Tan

摘要

Background

Monoclonal gammopathy of undetermined significance (MGUS) has been associated with thromboembolic and cardiovascular complications; however, its prognostic significance in patients with cerebral infarction (CI) remains unclear. This study investigated the association between MGUS and long-term outcomes in CI and evaluated the predictive value of MGUS for CI prognosis.

Methods

In this retrospective propensity score-matched cohort study, 60 CI patients with MGUS and 360 matched CI patients without MGUS were enrolled from Zhongshan Hospital. Patients were followed for a median of 5.8 years, with all-cause mortality as the primary endpoint. Kaplan–Meier survival analysis and Cox proportional hazards models were applied to assess prognostic associations. A prognostic nomogram was developed in a training cohort and validated in an independent test cohort.

Results

Patients with CI and concomitant MGUS exhibited significantly higher all-cause mortality compared with those without MGUS (log-rank p = 0.017). After adjustment for confounding variables, MGUS remained independently associated with increased mortality risk (hazard ratio 2.47; 95% CI 1.25–4.90; p = 0.009). A nomogram incorporating MGUS, age, modified Rankin Scale score, and D-dimer demonstrated strong discrimination, with C-indices of 0.837 in the training set and 0.792 in the validation set.

Conclusion

MGUS is independently associated with poor long-term prognosis in patients with cerebral infarction. Incorporation of MGUS into prognostic assessment improves risk stratification and may inform individualized management strategies for CI patients.