Association of microalbuminuria with stroke severity and infarct size in acute ischemic stroke: a prospective case-control study

Background: Microalbuminuria (MAU), a marker of systemic endothelial dysfunction, has been increasingly recognized for its association with cardiovascular and cerebrovascular diseases. This study aimed to evaluate the relationship between microalbuminuria and the severity of acute ischemic stroke, assessed using the National Institutes of Health Stroke Scale (NIHSS), and to determine whether microalbuminuria can serve as a predictor of infarct size and neurological impairment. Methods: A total of 60 patients diagnosed with acute ischemic stroke were enrolled. Spot urine samples were analyzed for microalbuminuria, and stroke severity was assessed using the NIHSS. Infarct size was categorized as either small (SI) or large (LI) based on radiological findings. Statistical analysis was performed to evaluate the correlation between microalbuminuria and stroke severity. Results: Spot microalbuminuria was detected in 70.0% of cases compared to 10.0% of controls, with a statistically significant association (p = 0.000). A strong correlation was observed between microalbuminuria and stroke severity based on NIHSS scores at admission and one month later (p = 0.000), with higher microalbuminuria prevalence in moderate to severe and severe stroke categories. Stroke size also correlated with microalbuminuria, with larger infarcts more frequently associated with its presence. Conclusion: The presence of microalbuminuria is significantly associated with both infarct size and stroke severity in acute ischemic stroke patients. These findings suggest that microalbuminuria could serve as a simple, cost-effective prognostic biomarker in the clinical assessment of stroke severity. Incorporating microalbuminuria screening in acute stroke management may enhance early risk stratification and guide therapeutic decisions.