Plasma Metabolomics of Thrombectomy-Treated Patients Highlights Metabolic Pathways Underlying Disease and Recovery

Thrombosis, characterized by pathological intravascular clot formation, underlies major clinical events such as cerebral infarction, myocardial infarction, and pulmonary embolism. However, metabolomic alterations associated with cerebral infarction, particularly those distinguishing patients with different clinical outcomes after recanalization, remain poorly characterized. This study aimed to provide an unbiased, systems-level characterization of metabolic alterations in cerebral infarction thrombosis.

We performed LC-MS/MS-based untargeted plasma metabolomics in both positive and negative ion modes. The cohort included 24 patients with meaningful functional recovery after cerebral infarction thrombectomy (MFR), 21 patients with futile recanalization (FTR), and 20 healthy controls (CON). Global metabolomic profiles were analyzed using multivariate and univariate approaches, followed by KEGG pathway enrichment analysis.

Plasma metabolite profiles differed significantly among groups. Both MFR and FTR patients exhibited marked metabolic perturbations relative to controls, while the MFR group showed subtle but distinct metabolic patterns compared with FTR patients. Differential metabolites were enriched in pathways related to mitochondrial function, lipid signaling, amino acid metabolism, and inflammatory regulation, which are associated with endothelial function and thrombo-inflammatory responses in cerebral infarction.

This study identifies metabolic alterations associated with cerebral infarction thrombosis and clinical outcome status following recanalization. These findings highlight candidate metabolites and pathways that may inform future mechanistic studies and biomarker validation specific to cerebral infarction.