Abstract: Objective To investigate the relationship between serum high-sensitivity cardiac troponin T （hs-cTnT）, S100B, high-sensitivity C-reactive protein （hs-CRP） and thrombo-inflammation facotrs in patients with first-ever acute ischemic stroke （AIS）, and evaluate the value of hs-cTnt within 6 h after AIS onset in predicting neurological outcome. Methods A total of 106 patients with first-ever AIS were enrolled. Serum hs-cTnT, S100B, hs-CRP, monocyte chemoattractant protein-1 （MCP-1）, thrombus-inflammatory markers including soluble CD40 ligand （sCD40L）, tissue plasminogen activator （t-PA） and P-selectin were determined within 6 h and 72 h after AIS onset. The National Institutes of Health Stroke Scale （NIHSS） score combined with the modified Rankin Scale （mRS） score were used to evaluate the prognosis of neurological outcomes upon admission and 90 d after AIS onset. All patients were divided into the poor and excellent prognosis groups according to the neurological outcomes at 90 d after AIS onset. All parameters were statistically compared between two groups. The correlation between hs-cTnT and thrombus-inflammatory molecules was analyzed. And the value of those indexes in predicting neurological outcome were statistical analysis. Results Sixty-two patients were assigned into the poor prognosis group and 44 cases into the excellent prognosis group. Within 6 h after onset, the serum levels of hs-cTnT, hs-CRP, MCP-1, tPA and sCD40L in the poor prognosis group were significantly higer than those in the excellent prognosis group （all P < 0.05）. At 72 h after onset, the serum levels of hs-cTnT, S100B, hs-CRP and sCD40L in the poor prognosis group were significantly lower compared with those in the excellent prognosis group （all P < 0.05）. Within 6 h and 72 h after onset, the serum level of hs-cTnT was positively correlated with the hs-CRP level at 72 h after onset （r = 0.585, P < 0.001; r = 0.599, P < 0.001）, positively correlated with the t-PA level within 6 h after onset （r = 0.551, P = 0.001 and r = 0.547, P = 0.002）, and positively associated with the MCP-1 level within 6 h after onset （r = 0.475, P = 0.014; r = 0.462, P = 0.015）. The baseline NIHSS score ≥8 （OR = 2.656, 95% CI 1.009-6.995,P = 0.048）, hs-cTnT within 6 h after onset （OR = 6.050, 95%CI 2.352-15.560, P < 0.001）, hs-CRP （OR = 7.294, 95%CI 3.285-16.195, P < 0.001）, MCP-1 （OR = 1.349, 95%CI 1.002-1.818, P = 0.049） and t-PA （OR = 1.007, 95%CI 0.692-2.446, P = 0.004） were the risk factors for poor neurological function. Conclusion Elevated hs-cTnT level within 6 h after onset of AIS is an independent predictor of poor neurological outcome, which is also correlated with the acute increase of hs-CRP, t-PA and MCP-1 levels.