ABSTRACT NUMBER: ESOC2026A104 INFLAMMATORY AND METABOLIC BIOMARKERS IN CARDIOEMBOLIC STROKE: ABOUT A TUNISIAN COHORT

Abstract Background and aims Cardioembolic stroke (CES) represents a major subtype of ischemic stroke, often marked by greater neurological severity due to embolic occlusion of large cerebral arteries. Beyond traditional vascular risk factors, systemic inflammation and metabolic stress are increasingly recognized as modulators of cerebral injury. However, data from North African populations remain limited. This study aimed to assess the relationship between inflammatory and metabolic indices and initial stroke severity in Tunisian patients with CES. Methods A retrospective study was conducted at the Neurology Department of Fattouma Bourguiba University Hospital between January 2023 and June 2025, including 334 ischemic strokes, of which 119 were cardioembolic. Patients were stratified by initial stroke severity (NIHSS ≤ 5 vs > 5). Derived admission indices included NLR, SII, SIRI, CLR, TyG, AIP, MHR, glucose, and HbA1c. Non-parametric tests and ROC analyses were used for comparisons and cut-off determinations. Results Among 119 CES patients (mean age 67.6 ± 17.4 years; 52% male), 75 presented severe deficits. Severe cases showed higher NLR (p = 0.0002), SII (p = 0.0066), SIRI (p = 0.012), and CLR (p < 0.0001). ROC curves identified CLR (AUC = 0.764; cut-off = 0.005) and NLR (AUC = 0.723; cut-off = 3.65) as best discriminators. Admission glucose was also higher in severe CES (p = 0.0057). Conclusions Elevated systemic inflammatory markers, particularly CLR and NLR, and acute hyperglycemia were strongly associated with initial CES severity, underscoring their potential role in early prognostic assessment. Conflict of interest nothing to disclose