HIR was the primary determinant of IGR, with higher HIR significantly associated with accelerated infarct growth (adjusted OR = 18.75, 95% CI: 2.45-143.54; <i>p</i> = 0.005).<h4>Conclusion</h4>Hypertension, baseline NIHSS score, IGR, HIR, and cystatin C levels are independent predictors of poor functional outcome despite successful recanalization. Here, CST3 is linked to infarction.