Abstract Details

Title Impact of INR on Functional and Survival Outcomes following Mechanical Thrombectomy for Stroke Patients with Large Vessel Occlusion

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) Cerebrovascular Disease and Interventional Neurology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 046

Objective To assess the impact of INR on functional and survival outcomes following mechanical thrombectomy (MT) for stroke patients with large vessel occlusion (LVO).

Background MT is an effective treatment for ischemic stroke due to LVO. Whether INR affects MT outcomes remains unclear.

Design/Methods In this retrospective observational study, we identified consecutive patients at a Comprehensive Stroke Center who underwent MT for LVOs involving the intracranial ICA or M1/M2 segments of the MCA. Patient baseline information include demographic information, past medical history, INR, admission NIHSS, tPA administration, and stroke onset to groin puncture time. Outcome measures include TICI scores, in-hospital and 90-day mortality, length of hospital stay (LOS), and modified Rankin Scores (mRS) at discharge and 90 days.

Results 433 patients were included. 28 patients had an elevated INR (≥ 1.5), and, compared with patients with an INR < 1.5, these patients were older (75 vs. 66 years, p=0.002), more likely to have atrial fibrillation (80% vs 36%, p<0.0005), and less likely to have received tPA (18.5% vs. 50.2%, p=0.001). Bivariate, unadjusted comparisons revealed that an INR ≥ 1.5 did not impact TICI scores, LOS, mRS at discharge or 90 days, or in-hospital mortality (p>0.05 for all). 90-day mortality was higher among patients with INR ≥ 1.5 (37% vs. 21%, p=0.050). Multivariate analyses adjusting for age, sex, NIHSS, onset-to-groin puncture time, and successful reperfusion (TICI ≥ 2b) showed that INR as a continuous variable is positively associated with odds of 90-day mortality (Adjusted OR=2.373, p=0.063). Overall, INR was not significantly associated with any outcome measure (p>0.05 for all).

Conclusions Elevated INR does not significantly impact functional or survival outcomes following MT. While a higher INR is associated with increased 90-day mortality, whether this trend reflects a direct impact of INR on MT outcomes or differences in patient groups unrelated to MT requires further investigation.

Authors/Disclosures
Huanwen Chen, MD (MedStar Georgetown University Hospital) PRESENTER	Dr. Chen has nothing to disclose.
Karen Yarbrough (University of Maryland Medical Center)	No disclosure on file
Anant Walia, MD (University of Maryland Medical Center)	Mr. Walia has nothing to disclose.
Michael Phipps, MD, MHS, F�鶹��ýӳ�� (University of Maryland School of Medicine)	Dr. Phipps has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMJ.
Carolyn Cronin, MD, PhD, F�鶹��ýӳ�� (Vanderbilt University Medical Center)	Dr. Cronin has nothing to disclose.
Prachi Mehndiratta, MD	Dr. Mehndiratta has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Seemant Chaturvedi, MD, FAHA, F�鶹��ýӳ�� (University of Maryland)	Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Chaturvedi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Chaturvedi has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Heart Association. The institution of Dr. Chaturvedi has received research support from NINDS.

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