BackgroundNardilysin, a kind of metalloendopeptidase, plays an important role in numerous inflammatory diseases. Malignant cerebral infarction (Glasgow coma scale score of <9) is associated with a high mortality risk. Here, we intended to investigate the relationship between serum nardilysin levels and prognosis of patients with malignant cerebral infarction. MethodsSerum nardilysin concentrations were quantified at malignant cerebral infarction diagnosis moment in 105 patients and at study entrance in 105 healthy controls. Association of nardilysin concentrations with 30-day mortality and overall survival was estimated using multivariate analyses. ResultsThe patients exhibited substantially increased serum nardilysin concentrations, as compared to the controls. Nardilysin concentrations were in pronounced correlation with Glasgow coma scale scores and serum C-reactive protein concentrations. Serum nardilysin was independently predictive of 30-day mortality and overall survival. Under receiver operating characteristic curve, its high discriminatory ability was found. ConclusionsRising serum nardilysin concentrations following malignant cerebral infarction are strongly related to stroke severity, inflammatory extent and a higher risk of mortality, substantializing serum nardilysin as a potential prognostic biomarker for malignant cerebral infarction.