Abstract WP161: Does History Of Atrial Fibrillation (Afib) Impact TICI Scores In Acute Ischemic Stroke Patients Receiving Endovascular Treatment With Or Without Iv Thrombolytics? Results From A Large Health System In Six Western States Of The United States

Abstract

Introduction: Despite the importance of Afib in stroke, it is unclear whether patients with acute ischemic stroke (AIS) and Afib have a different response to reperfusion with IV thrombolysis (IVT) and/or endovascular treatment (EVT) compared to non-Afib patients. Patients with AIS due to Afib may have difficulty achieving favorable TICI scores (The thrombolysis in cerebral infarction).This study aimed to compare the TICI scores in patients with and without a history of Afib treated with EVT and/or IVT. Methods: Data on consecutive AIS patients (a multi-state health system’s stroke registry) treated with EVT and/or IVT for five years (2018 -2022) were evaluated. Patients were stratified into two groups, 1- EVT only with or without a history of Afib; 2- IVT plus EVT with or without a history of Afib.Multivariable mixed effect logistic regressions were performed to evaluate if patients with AFib showed a difference in TICI scores (favorable outcome : TICI: 2b-3) within the two treatment groups adjusting for patient age, sex, race and ethnicity, NIHSS on admission, blood glucose on admission, SBP on admission and history of diabetes, CAD/prior MI, carotid stenosis, smoking, dyslipidemia, heart failure, or being overweight. Results: The cohort consists of 3311 patients with a median age at arrival 73 years and median NIH Stroke scale 16, who were 51.7% females, 68% white, 23.9% diabetes mellitus, 51.6% dyslipidemia , 20.5% CAD , 13.6% smoking, 53.6% overweight, 14.9% HF.In group 1 (EVT) :2350 patients:37.3% had Afib and 93.6% achieved a score of TICI 2b-3 .In group 2 (EVT+IVT): There were 961 patients, 28.7% having Afib with 94.9% achieving TICI 2b-3. After adjustment, there was no difference in the TICI scores between two groups . Conclusions: In this study, atrial fibrillation did not significantly impact TICI scores in AIS patients treated with EVT. The study also supports the efficacy of EVT in combination with IVT in the population with Afib.