The relationship between serum ischemia-modified albumin levels and prognosis in acute ischemic stroke

Aim: This study aimed to investigate the association between serum ischemia-modified albumin (IMA) levels, stroke severity, and functional outcomes in adult patients diagnosed with acute ischemic stroke (AIS) in the emergency department. Material and Methods: In this prospective observational study, 40 AIS patients and 20 age- and sex-matched healthy controls were enrolled. Serum IMA levels were measured at admission using a commercial ELISA kit. Stroke severity was assessed with the National Institutes of Health Stroke Scale (NIHSS), and functional outcomes at 3 months were determined using the modified Rankin Scale (mRS), with scores ≥2 defined as poor functional outcome (PFO). Results: Median IMA levels were significantly higher in AIS patients than controls. Elevated IMA was independently associated with AIS (adjusted OR: 1.18, 95% CI: 1.03–1.35, p = 0.015), severe stroke (adjusted OR: 1.38, 95% CI: 1.06–1.83, p = 0.018), and PFO at 3 months (adjusted OR: 1.16, 95% CI: 1.04–1.30, p = 0.008). ROC analysis identified IMA cutoffs of >58 ng/mL for AIS (AUC: 0.859), >76.7 ng/mL for severe stroke (AUC: 0.890), and >65.4 ng/mL for PFO (AUC: 0.854). Conclusion: Serum IMA levels are elevated in AIS and correlate with both initial stroke severity and short-term functional outcomes. IMA may serve as a rapid, cost-effective biomarker for early risk stratification in AIS.