Abstract Number: Esoc2026lb200 Inflammatory Indices and MMP-12 Rs2276109 Polymorphism Differentiate Cardioembolic From Atherothrombotic Ischemic Stroke and Improve Early Outcome Prediction in Patients of Uzbek Ethnicity

Abstract Background and aims Cardioembolic stroke is associated with a severe clinical course and poorer outcomes. However, reliable bio and genetic markers for early risk stratification remain limited. The study aimed to evaluate the role of systemic inflammatory indices and matrix metalloproteinase gene polymorphisms in differentiating the cardioembolic subtype and in improving early outcome prediction. Methods A total of 196 patients were enrolled, 97 patients with cardioembolic and 99 with atherothrombotic subtype. Neurological severity and functional status were assessed using the NIHSS and mRS on day 1, 7 and at 3 months. The neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation (SII) and platelet-to-lymphocyte ratio (PLR) were calculated at admission. Genotyping of MMP-12 rs2276109 was performed using polymerase chain reaction-based methods. Multivariable logistic regression and receiver operating characteristic analyses were applied. Results Patients with cardioembolic stroke showed significantly higher NLR, SII and PLR compared with the atherothrombotic group (all p 0.001) and had consistently higher NIHSS and mRS scores (all p 0.001). The MMP-12 rs2276109 polymorphism was significantly associated with the cardioembolic subtype (allelic model OR 2.09, 95% CI 1.36–3.21, p = 0.0009; dominant model OR 2.30, 95% CI 1.28–4.14, p = 0.005). MMP-12 genotypes were significantly associated with NLR and SII (p = 0.00009 and p = 0.00012, respectively). In predictive analyses, a combined model including NIHSS and MMP-12 achieved high discriminative performance in cardioembolic stroke (AUC 0.942). Conclusions Systemic inflammatory indices and the MMP-12 rs2276109 polymorphism differentiate cardioembolic stroke subtype with improving early outcome prediction and early risk stratification. Conflict of interest