Background: Acute ischemic stroke (AIS) induces a severity of inflammatory response that varies depending on the individual and may depend on the type of reperfusion treatment used. The aim of this study was to compare values of inflammatory response indices between AIS patients treated with endovascular mechanical thrombectomy (EMT) only and those in whom EMT was preceded by intravenous thrombolysis (IVT). Patients and methods: Retrospective analysis of medical documentation of 2242 consecutive, real-world patients hospitalized in one center due to AIS between 1 January 2014 and 31 May 2025. Several single and composite inflammatory indices were analyzed. Results: Patients who underwent double reperfusion treatment (IVT + EMT) (n = 1201; 53.57%) had lower C-reactive protein (CRP)-to-albumin, CRP-to-lymphocyte, CRP-to-neutrophil, and CRP-to-platelet ratios; lower platelet-to-lymphocyte, platelet-to-albumin, and platelet-to-hemoglobin ratios; and a lower inflammatory burden and systemic inflammatory index than those who were treated only with EMT (n = 1041; 46.43%). Compared to patients treated only with EMT, those treated with IVT + EMT also had a shorter length of in-hospital stay, were less likely to be readmitted within 14 days of discharge, and were more likely to achieve a modified Rankin score of 0–1 at discharge. Conclusions: Patients with AIS treated with IVT + EMT may exert a lower inflammatory magnitude of response and better functional status at discharge than those treated with EMT only. Biomarkers of inflammatory response to AIS require further study to confirm their usefulness in AIS patients’ management and personalized qualification for reperfusion and non-reperfusion targeted treatment.
Świtońska et al. (Tue,) studied this question.