Abstract TP14: Does Atrial Fibrillation (Afib) Impact The Rate Of 90 Days Modified Rankin Scale (mRS) In Patients Who Received Intravenous Thrombolytic (IVT) Before Endovascular Treatment (EVT)?results From A Large Health System In Six Western States Of The United States

Abstract

Introduction: Previous studies indicate patients with acute ischemic stroke (AIS) due to Afib may not respond well to intravenous thrombolysis (IVT) compared to those without Afib. We assessed the association between a history of atrial Afib, good 90-day mRS (≤2), and the rate of symptomatic intracerebral hemorrhage (sICH) in patients treated with IVT and/or EVT. Methods: Data from a multi-state health system’s stroke registry for patients who received acute stroke treatment and were discharged between 2018 and 2022 were used. Patients were stratified into groups 1:EVT only with or without Afib; 2: IVT plus EVT with or without Afib; 3:IVT only with or without Afib.Multivariable mixed-effect logistic regression was performed and adjusted for baseline NIHSS, age, sex, race, and ethnicity, NIHSS on admission, blood glucose on admission, SBP at admission, and history of diabetes, CAD/prior MI, carotid stenosis, smoking, dyslipidemia, heart failure, being overweight, or renal insufficiency Results: Overall, 2558 patients who underwent AIS treatment had a 90-day mRS, of whom 30% had a history of AFib, 48% had a 90-day mRS 0-2; with the median age at arrival 72 years,73% white, median NIHSS was 9, 27% diabetes, 21% CAD, 4% carotid stenosis, 13% smoker, 60% dyslipidemia, 13% HF, 62% overweight, 11% chronic renal insufficiency, median SBP 153 mmHg, median glucose 124.Among group 1(n=978): 39.4% had Afib, 36.1% had a 90-day mRS 0-2 and 5% had sICH .In group 2 (n=402): 28.1% had Afib, 44.3% had a 90-day mRS 0-2 and 5.9% had sICH. In group 3(n=1178): 16.1% had Afib, 59.9% had a 90-day mRS of 0-2, and 2.6% had sICH.After adjustment, there was no association between Afib and 90-day mRS in any group. Also, the rate of sICH did not significantly differ between Afib and non-Afib patients. Conclusions: History of Afib did not significantly impact favorable functional outcomes or the rate of sICH in patients who underwent EVT with or without intravenous thrombolytics.