A Narrative Review of Peripheral Blood Markers for Stroke Prognosis

With stroke becoming the main cause of global morbidity and mortality. The urgent demand for reliable biomarkers to enhance prognostic accuracy and guide individualized clinical decision-making has never been more pronounced. This unmet need is amplified by the disease’s heterogeneous etiologies and variable clinical trajectories, which often hinder timely risk stratification and targeted intervention for stroke patients. A growing body of research has delved into diverse categories of candidate biomarkers, encompassing inflammatory mediators, metabolic indicators, and blood cellular parameters and evaluated their potential in predicting short-term and long-term stroke outcomes such as functional independence, recurrence risk, and mortality. Through a narrative review of current literature, we have summarized key biomarkers such as C-reactive protein, interleukins, blood cells, lipid profiles, oxidative stress markers, microparticles and cell-free DNA, clarifying their associations with stroke pathophysiology and clinical endpoints. Simultaneously, we highlighted critical gaps and inconsistencies in existing studies, such as limited validation in multiethnic and underrepresented patient cohorts. Furthermore, we have discussed the practical clinical applications and inherent challenges of translating these biomarkers into real-world settings. Finally, we have proposed future research directions, emphasizing the development of standardized protocols, validation in large-scale prospective cohorts, and exploration of multiple biomarkers to address unmet clinical needs in stroke management.