Abstract Details

Title Analysis of Protein Networks Associated with Hemorrhagic Conversion In Emergent Large Vessel Occlusion Patients Undergoing Mechanical Thrombectomy

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 13-003

Objective

We evaluated associations between proteomic changes in blood during acute ischemic stroke obtained during mechanical thrombectomy and hemorrhagic conversion of infarction.

Background

Hemorrhagic conversion (HC) is a common complication of ischemic strokes, especially following reperfusion which contributes to increased mortality. Not much is known about predicting the likelihood and extent of HC.

Design/Methods

The Blood And Clot Thrombectomy Registry And Collaboration (BACTRAC) is a biobank (clinicaltrials.gov NCT03153683) and registry of adult stroke patients undergoing mechanical thrombectomy. Blood samples from systemic arterial blood (internal carotid artery) of sixty-one patients were collected and sent to Olink Proteomics (Olink Proteomics, Boston, Massachusetts, USA) for proteomic analysis of 92 cardiometabolic and inflammatory proteins. Independent t-tests/Fischer’s-exact were used to examine associations between 184 proteins and subtypes of HC from European Cooperative Acute Stroke Study (ECASS): Hemorrhagic Infarction (HI 1 and 2) and Parenchymal Hematoma (PH 1 and 2). STRING V11 was then used to visualize networking between significant proteins. Data analyses were performed using IBM SPSS Statistics and STRING V11.

Results Among 61 patients with HC (HI n=36 and PH n=5), 70% had hypertension, 51% had type-2 Diabetes, 27% had hyperlipidemia, and 12% had history of stroke. T-test showed that proteins: angiopoietin-like protein 3(ANGPTL3), fibroblast growth factor 21/23 (FGF21 and FGF23), interleukin ten(IL10), and leukocyte immunoglobulin-like receptor family member B (LILRB2) were all significantly higher in patients with HC(PH and HI) than those without HC(p<0.05). Proteins that were significantly elevated in HI-type HC were cell adhesion molecule L1-like protein(CHL1), Interleukin 7 receptor(IL7R), neurotrophin 3(NT3), and thymic stromal lymphopoietin(p<0.05). STRING algorithm output demonstrates protein-protein interactions for both subgroups of hemorrhagic conversion.

Conclusions

This study demonstrates network proteins and changes associated with hemorrhagic conversion in ischemic strokes following mechanical thrombectomy. This will allow future studies to develop predictive biomarkers and proteomic targets to administer adjunctive therapies to thrombectomy.

Authors/Disclosures
Madison Sands PRESENTER	Ms. Sands has nothing to disclose.
Chintan K. Rupareliya, MD (Ochsner Health Center)	Dr. Rupareliya has nothing to disclose.
	No disclosure on file
Christopher McLouth (University of Kentucky)	Christopher McLouth has nothing to disclose.
Benton Maglinger, MD (BIDMC)	Mr. Maglinger has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Shivani Pahwa, MD	Dr. Pahwa has nothing to disclose.
Lila E. Sheikhi, MD (Hawthorn Health, LLC)	Dr. Sheikhi has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file

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