Serum Biomarkers in Acute Ischemic Stroke: Clinical Applications and Emerging Insights

Acute ischemic stroke (AIS) remains a major cause of long-term disability and death worldwide, posing significant challenges to healthcare systems. Timely diagnosis is crucial, as acute phase therapeutic options are highly time-sensitive and most effective when administered early in the disease course. In this context, serum biomarkers have emerged as a promising and complementary tool to aid in the rapid and accurate diagnosis, prognosis, and therapeutic monitoring of AIS. This narrative review aims to provide a comprehensive overview of the current landscape of serum biomarkers relevant to AIS. These biomarkers are categorized based on the underlying pathophysiological mechanisms they reflect, including markers of inflammation and oxidative stress, neuronal and endothelial injury, and those related to hemostasis and fibrinolysis. Their biological significance is evaluated through the spectrum of their diagnostic sensitivity and specificity and their potential integration into clinical practice. In addition, many of these biomarkers offer prognostic insights, helping to predict the likelihood of complications, recurrent stroke, or poor functional recovery. Furthermore, their role as a potential tool for the differential diagnosis of patients presenting with minor or nonspecific neurological symptoms and therapeutic monitoring is emphasized. Despite the promising potential of these biomarkers, their translation into routine clinical use remains limited.