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Abstract Details

Tachycardia is Associated with Mortality after Thrombectomy for Acute Ischemic Stroke
Cerebrovascular Disease and Interventional Neurology
P14 - Poster Session 14 (11:45 AM-12:45 PM)
13-003
NA

The relationship between cardiac function and mortality after thrombectomy for acute ischemic stroke is not well elucidated. 

We analyzed the relationship between cardiac function and mortality prior to discharge in a cohort of patients who underwent thrombectomy for acute ischemic stroke at two large medical centers in New York City between December 2018 and November 2020.  Cardiac function was evaluated using initial heart rate (HR), maximum HR over admission, ejection fraction (EF), presence of left ventricular hypertrophy (LVH) and left ventricular wall motion abnormalities (WMA) on transthoracic echocardiogram, first and highest troponin of admission, history of CHF and atrial fibrillation (AF), and presence of NSTEMI or STEMI during admission. Analyses were performed using Welch’s two sample t-test and logistic regression accounting for initial NIHSS and post-thrombectomy ASPECTS score, where OR is for each unit increase in the respective variables.
Of 254 patients, 42 (16.5%) died prior to discharge. Mortality was significantly associated with higher initial HR (89 ± 19 bpm vs 80 ± 18 bpm, p = 0.0048) and higher maximum HR over entire admission (137 ± 25 bpm vs 114 ± 25 bpm, p < 0.0001). Mortality was also associated with a presence of NSTEMI or STEMI (61.9% vs 29.2%, p = 0.0001).  There was no relationship between mortality and EF, LVH, WMA, first and highest troponin of admission, and history of CHF or AF. When post-thrombectomy ASPECTS score and initial NIHSS were included in multivariate analysis, there was still a significant relationship between mortality and initial HR (OR 1.03, 95% CI 1.01- 1.05, p = 0.017), maximum HR over the entire admission (OR 1.03, 95% CI 1.02-1.05, p < 0.0001), and presence of STEMI or NSTEMI (OR 3.65, 95% CI 1.67-8.28, p = 0.0014). 

Tachycardia may be a risk factor for mortality in patients who undergo thrombectomy.

Authors/Disclosures
Ariane Lewis, MD, FAAN (NYU Langone Medical Center)
PRESENTER 		Dr. Lewis has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Seminars in Neurology. Dr. Lewis 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 Journal of Clinical Neuroscience.
Penina Krieger, MD (Penina Krieger) Ms. Krieger has nothing to disclose.
Amanda Zhao, MD Dr. Zhao has nothing to disclose.
Leah Croll, MD (NYU Langone Dept of Neurology) Dr. Croll has nothing to disclose.
Hannah Irvine, MD (NYU Langone Medical Center) Dr. Irvine has nothing to disclose.
Jose L. Torres, MD (NYU) Dr. Torres has nothing to disclose.
Kara R. Melmed, MD (NYU Langone Neurology Associates) Dr. Melmed has nothing to disclose.
Aaron Lord, MD (NYU Langone-Brooklyn) Dr. Lord has nothing to disclose.
Koto Ishida, MD, FAAN (NYU) Dr. Ishida has received publishing royalties from a publication relating to health care.
Jennifer A. Frontera, MD (NYU Langone Health) Dr. Frontera has received personal compensation in the range of $500-$4,999 for serving as a Consultant for FirstKindMedical. Dr. Frontera has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Physician 好色先生 Resource. The institution of Dr. Frontera has received research support from NIH. The institution of Dr. Frontera has received research support from Alexion. Dr. Frontera has received publishing royalties from a publication relating to health care.