Objective:

To develop and internally validate an inflammation-platelet synergy score for distinguishing patients with anterior circulation cerebral infarction from high-risk controls.

Approach:

• Study Design: Retrospective case-control study enrolling 203 patients with anterior circulation cerebral infarction and 98 high-risk controls with carotid atherosclerosis.
• Synergy Score Parameters: The score included CRP, MPV, PDW, platelet count, IMT, and unstable plaque status.
• Assessment Methods: Discriminative performance was assessed using receiver operating characteristic analysis with bootstrap internal validation and decision curve analysis for clinical utility.

Key Findings:

• Cases had significantly elevated CRP, MPV, and IMT compared to controls (p < 0.001).
• The synergy score showed good discriminative ability (AUC = 0.824).
• Cerebral infarction prevalence increased from 36.0% in low-risk to 87.2% in high-risk groups.
• Higher scores were associated with greater stroke severity and unfavorable functional outcomes.

Interpretation:

The inflammation-platelet synergy score demonstrated good discriminative ability for anterior circulation cerebral infarction using routinely available parameters.

Limitations:

• Findings require prospective validation with pre-event biomarker measurement.
• Study is exploratory and may not generalize to broader populations.
• Potential biases inherent in retrospective study designs should be considered.

Conclusion:

Preliminary findings require further validation before any clinical application can be considered.