Abstract Number ‐ 150: Association of 24‐hour Blood Pressure Parameters Post‐thrombectomy with Mortality in Anemic and Non‐anemic Patients

Abstract

Introduction Higher blood pressure (BP) is considered to be harmful in patients who undergo mechanical thrombectomy (MT), however, the impact of BP post‐MT based on comorbidities like anemia has not been well studied. We aim to determine the association of 24‐h post‐MT BP parameters with mortality depending on the anemia status. Methods We conducted a retrospective chart review of patients who underwent MT at a comprehensive stroke center from 7/2014 to 12/2020. Patients were dichotomized into anemic and non‐anemic groups based on the World Health Organization’s definition of anemia [hemoglobin < 12.0 g/dL in women and < 13.0 g/dL in men]. We performed a binary logistic regression analysis controlling for baseline parameters, with the 24‐h post‐MT BP parameters as predictors. The primary outcome was 3‐month mortality. Results 220 patients met the inclusion criteria. The 3‐month mortality rate was 27.27%. In the multivariable analysis, the 24‐h parameters of a lower mean DBP (65.53±9.73 vs. 71.94±10.16; OR, 0.92; 95% CI, 0.86‐0.98; P 0.007), lower mean MAP (85.7±8.65 vs. 91.38±10; OR, 0.93; 95% CI, 0.86‐0.99; P 0.02), a lower minimum DBP (49.27±10.51 vs. 55.1±11.23; OR, 0.93; 95% CI, 0.88‐0.99; P 0.019), a lower minimum MAP (68.96±9.54 vs. 74.73±10.47; OR, 0.93; 95% CI, 0.87‐0.99; P 0.023) were significantly associated with mortality in patients with anemia. There was no association between 24‐hour BP Parameters post‐MT and mortality in non‐anemic patients. Conclusions In our study, lower BP parameters were associated with higher 3‐month mortality in anemic patients, however, this effect was not found in non‐anemic patients. Anemia induces a relative hypoxic state in target tissue in the event of an increase in metabolic demand such as stroke. Higher BP post‐MT can potentially promote perfusion and thus is not associated with worse outcomes in anemic patients post‐MT, whereas in non‐anemic patients it may potentially lead to reperfusion injury.