Abstract WP162: Endovascular Thrombectomy In Hispanic Stroke Patients Along The Texas-Mexico Border: Direct Comparison With The HERMES Trial

Abstract

Background and Purpose: Current evidence has shown that race and ethnicity impact the outcomes in acute ischemic stroke (AIS) patients secondary to large vessel occlusion. However, there is limited evidence concerning the utility of endovascular thrombectomy and AIS outcomes in Hispanic Americans. This study aims to compare the characteristics and outcomes between a majority Hispanic population and patients from the HERMES trial. Methods: We conducted a retrospective analysis from January 2013 to August 2020 to retrieve data related to Hispanic individuals in an understudied area along the Texas-Mexico border. Then, the characteristics and outcomes were compared between this cohort (n=637) and the HERMES trial (n=634). Categorical variables were compared using the chi-squared test. Results: The median [IQR] age for our cohort was 72 [±20] years and 68 [±20] years for the HERMES cohort. Similar rates of females were observed in both groups. Our cohort had lower rates of smoking, but higher rates of hypertension and diabetes mellitus (p<0.05). The median [IQR] admission NIHSS was 17.0 [11.0] vs. 17 [6.0], respectively. We observed significantly lower rates of intravenous tissue-type plasminogen activator (IV tPA) in this cohort as compared to the HERMES trial. The modified Rankin Scale score after 90 days was similar between the two groups. However, this cohort had significantly higher rates of mortality (19.7% vs. 15.3%, p=0.042) and symptomatic intracranial hemorrhage (sICH) (10.3% vs. 4.4%, p<0.001). Conclusion: There are significantly higher rates of mortality and sICH in Hispanic AIS patients which can most likely be explained by the higher rates of hypertension, diabetes mellitus, and the lower rates of IV tPA utilization.