Abstract P797: Sex Specific Plasma Protein Changes During Thrombectomy

Abstract

Introduction: Sex differences in stroke have been apparent with premenopausal females having a lower incidence of stroke with better outcomes than postmenopausal females and males. We examined sex-specific outcomes and changes in plasma proteins following emergent large vessel occlusions. The previously published Blood and Clot Thrombectomy Registry and Collaboration (BACTRAC), clinicaltrials.gov NCT03153683, allows for analysis of plasma proteins both systemically and distal to the thrombus. Methods: Plasma samples, processed in accordance with the BACTRAC protocol, were sent to Olink to run cardiometabolic and inflammatory panels. Demographics are reported as mean±SEM. Significance determined in Prism with Mann-Whitney, t-test, or pair mixed-effect analysis. Results: We evaluated 34 subjects, >18 yrs old (20 females, 14 males) enrolled in BACTRAC. There was no significant difference in age (68.9±2.7, 65.4±4.5 yrs, respectively) or comorbidities (hypertension, diabetes, cholesterolemia). Interestingly, males had a larger (p<0.1) change in Modified Rankin Scale (mRS, premorbid-discharge, 3.4±1.8, 2.2±1.6, respectively) with larger infarcts (86,666±30,889 mm 3 , 36,228±10,943 mm 3 , respectively). This coincided with a lower (p<0.05) CTA collateral scores for males compared to females (0.64±0.67, 1.1±0.13, respectively). 12 proteins were significantly (p<0.1) higher in females, compared to males (5 proteins upregulated in both the systemic and intracranial, 3 systemic specific, and 4 intracranial specific). Males had 15 proteins significantly higher than females (3 proteins upregulated in both the systemic and intracranial, 12 systemic specific, and 0 intracranial specific). The most significant intracranial protein for females is coagulation factor XI (F11) and males is transforming growth factor beta-1 (TGFB1). Analysis of an additional 16 subjects has begun to validate the sex specific proteins. Conclusions: Unexpectedly, males have larger infarcts and less independence following large vessel occlusions in BACTRAC. We hypothesize this is due to fewer collaterals which leads to sex specific signaling patterns. Additional analysis of the plasma and subjects in BACTRAC are needed to target sex specific therapeutic.