This study demonstrated several important findings: (1) CK-MB ≥ 5 ng/mL, NIHSS score, SBP ≥ 160 mmHg, LDH ≥ 220 U/L, ALT ≥40 U/L, Neutrophil ratio ≥ 80%, and D-dimer ≥0.5 mg/L were identified as independent predictors of END, highlighting the relationship between systemic response and early stroke progression after IVT; (2) The CNS-LAND score showed good discrimination and calibration and was successfully validated in an independent cohort. Here, GPT is linked to stroke disorder.