Taylan ALTIPARMAK, Hale Zeynep BATUR ÇAĞLAYAN, Remzi SONAY, Bijen NAZLIEL
Turkish Journal of Cerebrovascular Diseases - 2026;32(1):21-29
Background: serum albumin and albumin based immunonutritional indices have been investigated as prognostic and/or risk factors in various vascular diseases. Based on this evidence, we aimed to evaluate their potential contribution to predicting stroke recurrence. Methods: albumin, Prognostic Nutritional Index (PNI), and C-Reactive Protein- albumin-lymphocyte (C allY) indices were analyzed in 963 patients retrospectively to assess differences for recurrence in 2 year median follow-up. logistic regression were constructed in three models, and cox regression analysis was also performed to assess temporal effect. Results: albumin (p = .002) and PNI (p = .032) were significantly associated with recurrence in comparative analyses. In logistic regression lower albumin quartiles-even within the normal range-were associated with recurrence (Q1<=3.7 g/dl: OR=2.36, 95%CI=1.27-4.38, p=.007; Q2=3.71-4.0 g/dl: OR=2.13, 95%CI=1.12-4.03, p=.021). after adjustment for other biochemical markers (free T4, potassium, uric acid), albumin retained its significance (Q1: OR=2.05, 95%CI=1.09-3.87; Q2: OR=2.00, 95%CI=1.05-3.83). however, when major clinical predictors (previous stroke and adherence to antithrombotic therapy) were added to the model, this statistical significance was lost. In Cox regression, previous stroke was the only variable that remained associated with recurrence. Discussion and Conclusion: albumin may represent a more stable indicator of nutritional risk compared with PNI and C allY, which are potentially more susceptible to fluctuations driven by lymphocyte count or inflammation. although malnutrition risk may contribute to recurrence, the predictive value of albumin does not exceed that of major clinical determinants. Therefore, albumin may serve as a complementary risk marker in secondary stroke prevention but is unlikely to function as an independent predictor.
