Abstract

Background: Acute ischemic stroke (AIS) remains a leading cause of disability worldwide, placing a significant burden on patients’ quality of life and healthcare systems. Pentraxin-3 (PTX-3), an inflammatory biomarker, may be associated with AIS prognosis; however, existing evidence is inconclusive.

Aims: To examine whether serum PTX-3 levels at admission are linked to the likelihood of poor functional outcomes in AIS patients.

Study Design: Systematic review and meta-analysis.

Methods: A comprehensive search of PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang databases was conducted to identify studies evaluating PTX-3 levels in AIS patients. Eligible studies included those that measured PTX-3 within 48 h of admission and evaluated outcomes using the modified Rankin Scale, with scores > 2 defined as poor outcomes. A random-effects model was used to calculate pooled odds ratios (ORs) and corresponding 95% confidence intervals (CIs).

Results: Ten cohort studies involving1202 AIS patients were included. Higher PTX-3 levels at admission were significantly associated with an increased risk of poor functional outcomes (OR, 2.06; 95% CI, 1.72-2.47; p < 0.001), with no significant heterogeneity (I² = 0%). Meta-regression showed that using higher PTX-3 cutoff values reported stronger associations (p < 0.05). Subgroup analyses confirmed consistent associations across study designs, patient characteristics, and timing of outcome assessment. The association was more pronounced in studies using a PTX-3 cutoff ≥ 3.3 ng/mL compared to those with a cutoff < 3.3 ng/mL.

Conclusion: Elevated serum PTX-3 levels at admission may serve as a prognostic biomarker for poor functional outcomes in AIS. Differences in PTX-3 cutoff values and potential residual confounding should also be considered. Further multicenter studies involving diverse populations are necessary to confirm these results and establish PTX-3 as a reliable prognostic indicator in clinical practice.