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ORIGINAL RESEARCH article

Front. Aging Neurosci.

Sec. Neuroinflammation and Neuropathy

This article is part of the Research TopicDissecting Vascular Dysfunction in Stroke: Using Translational Research Models to Advance Biomarkers Discovery and Preventative MedicineView all articles

Prognostic value of endothelial activation and stress index in mechanical thrombectomy for patients with acute ischemic stroke

Provisionally accepted
Xiaohua  ZhuXiaohua Zhu1Yunnan  LuYunnan Lu1Yaojia  XuYaojia Xu2Yongxin  LiYongxin Li1Qingyong  DaiQingyong Dai1Xia  ChangXia Chang2*
  • 1Wuxi Xishan People's Hospital, Wuxi, China
  • 2Zhangjiagang City First People's Hospital, Zhangjiagang, China

The final, formatted version of the article will be published soon.

Abstract Background and purpose: The Endothelial Activation and Stress Index (EASIX) is a marker of endothelial dysfunction. This study aimed to explore the association between the EASIX score and unfavorable outcome in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT) treatment. Methods: We enrolled AIS patients treated with MT from a multicenter study between June 2021 to September 2024. The EASIX score was calculated as lactate dehydrogenase (LDH) (U / L) × Creatinine (mg / dL) / Platelet Count (10 ^ 9 / L). The unfavorable outcome was defined as 90-day modified Rankin scale score 3-6. We used multivariable logistic regression models to investigate the association between EASIX score and unfavorable outcome. A restricted cubic spline analysis was conducted to describe the linear relationship between the EASIX score and unfavorable outcome. Results: A total of 406 patients (258 [63.5%] male and median age: 71 years) were included in this study. 181 (44.6%) patients experienced unfavorable outcome. The logistic regression models demonstrated a robust association between the EASIX score and unfavorable outcome (log2 transformed odds ratio [OR]: 1.41; 95% confidence interval [CI]: 1.19-1.70; P <0.001; tertile 3 vs. tertile 1 OR: 2.05; 95% CI: 1.14-3.55; P = 0.017). The restricted cubic spline analysis revealed a linearly increasing association between the EASIX score and the risk of unfavorable outcome (P for nonlinearity = 0.802). Conclusion: Higher EASIX levels were significantly related to unfavorable outcome in AIS patients treated with MT. EASIX score may serve as a valuable tool for early risk assessment and outcome prediction in AIS patients.

Keywords: Thrombectomy, Stroke, endothelial, dysfunction, prognosis

Received: 11 Aug 2025; Accepted: 26 Nov 2025.

Copyright: © 2025 Zhu, Lu, Xu, Li, Dai and Chang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Xia Chang

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