ABSTRACT NUMBER: ESOC2026A2077 NEUROD AND NNT1 AS PREDICTORS OF THE OUTCOMES IN ACUTE ISCHEMIC STROKE PATIENTS UNDERGOING MECHANICAL THROMBECTOMY

Abstract Background and aims Neurogenesis and blood–brain barrier (BBB) integrity contribute to outcomes in acute ischemic stroke (AIS). NeuroD is a transcription factor involved in neurogenesis. Netrin-1 (NNT-1) regulates neuronal growth and supports BBB integrity. This study aimed to evaluate NeuroD and NNT-1 as predictors of outcome in AIS patients undergoing mechanical thrombectomy (MT). Methods 40 patients undergoing MT, with/without IVT, and with/without Cerebrolysin as an add-on therapy. Serum NeuroD and NNT-1 levels were measured at baseline and after 7 days. Bayesian statistics and cluster analyses were performed. Results Diabetic patients undergoing MT/IVT with Cerebrolysin demonstrated stable NeuroD levels (89%), those not treated with Cerebrolysin showed no change (66%) or a decrease (33%) in NeuroD (BF₁₀=1.166). Non-diabetic patients receiving Cerebrolysin showed a smaller decrease in NeuroD levels (12%) compared with patients not treated with Cerebrolysin (100%) (BF₁₀=1.929). Lower NIHSS scores on day 3 (BF₁₀=11.95) and day 7 (BF₁₀=2.678) were associated with higher NNT-1 levels. First cluster : (absent NeuroD/high NNT-1) - greater improvement in NIHSS at 7 days after stroke onset, particularly in patients treated with MT+IVT (BF₁₀=4.212) and in those receiving Cerebrolysin as an add-on (BF₁₀=1.917). The second (present NeuroD/low NNT-1) -less improvement in 7-day NIHSS scores Conclusions NeuroD and NNT-1 predict outcomes in AIS patients undergoing MT. These biomarkers also demonstrate the beneficial effects of Cerebrolysin as an adjunct to reperfusion therapy Conflict of interest nothing to disclose