Objective: Early diagnosis of acute ischemic stroke patients with large vessel occlusion and the transfer of patients who require endovascular treatment to stroke centers specific for treatment are of critical importance for patients. Pentraxin-3 (PTX-3) is a biomarker indicating vascular inflammation, and its role in stroke and its relationship with clinical features are being investigated. In this study, the value of PTX-3 levels in the diagnosis of LVO and its relationship with clinical features were evaluated.

Methods: Retrospective and prospective patients diagnosed with acute ischemic stroke were included in this study. Patients were divided into two groups as those with and without LVO according to imaging findings. Serum PTX-3 levels were measured and compared between the groups. Stroke severity was evaluated at admission using the National Institutes of Health Stroke Scale (NIHSS), and clinical outcome was evaluated at the 90th day using the modified Rankin Scale (mRS). Correlation, ROC analysis, and logistic regression methods were used in statistical analyses.

Results: Data of 81 patients were analyzed in the study. Although PTX-3 levels were found to be higher in patients with LVO, this difference was not statistically significant. The discriminative power of PTX-3 for LVO was found to be limited (AUC = 0.58). A positive correlation was found between PTX-3 levels and admission NIHSS. Although an association between PTX-3 and poor clinical outcome was observed in univariate analyses, it was shown that it was not an independent marker in multivariable analyses. The addition of PTX-3 to clinical models did not increase predictive power.

Conclusion: In patients with acute ischemic stroke with LVO, PTX-3 was found not to be a sufficient biomarker in confirming the diagnosis. Although PTX-3 was found to be associated with stroke severity, it cannot predict clinical outcome on its own. Based on the current findings, PTX-3 does not appear to have a clear contribution to the clinical decision-making process.

Keywords: acute ischemic stroke, large vessel occlusion, pentraksin-3, clinical outcome