642 Impact of bridging therapy vs endovascular thrombectomy alone on outcomes in anticoagulated patients with atrial fibrillation presenting with mild-moderate ischaemic stroke
Published Date: 16th May 2023
Publication Authors: Abdul-Rahim A
Background and aims
The aim was to assess the impact of bridging intravenous thrombolysis (IVT) before endovascular thrombectomy (EVT), compared to EVT alone, in anticoagulated patients with atrial fibrillation (AF) presenting with mild-moderate acute ischaemic stroke.
Method(s)
A retrospective analysis (01/09/2018-01/09/2022) using a global health research network was conducted. Logistic regression models were used to compare intracerebral haemorrhage (ICH) and all-cause mortality at 30- and 90-days by whether the participants received bridging therapy (IVT+EVT) versus EVT only. Propensity-score matching was used to balance the two groups for characteristics including age, sex and co-morbidities.
Result(s)
In total, 1,238 patients with acute ischaemic stroke were treated with bridging therapy or EVT only. After propensity-score matching, 384 patients (mean (SD) age 72.7 (12.7); 49.2% female) received bridging therapy, and 384 patients (mean (SD) age 72.9 (12.7); 47.9% female) received EVT only. ICH occurred within 30- and 90-days in 52 (13.5%) and 56 (14.5%) in the bridging therapy group compared with 31 (8.0%) and 33 (8.6%) in EVT only group (odds ratios (ORs) 1.78, 95% confidence interval (CI): 1.11-2.85, and 1.81, 95%CI: 1.15-2.86). Death occurred within 30- and 90-days in 62 (16.1%) and 76 (19.7%) patients in the bridging therapy group compared to 59 (15.3%) and 76 (19.7%) in the EVT only group (ORs 1.06, 95%CI: 0.71-1.56, and 1.00, 95%CI: 0.70-1.42).
Conclusion(s)
In anticoagulated AF patients who presented with mildmoderate acute ischaemic stroke, bridging therapy compared to EVT alone was associated with higher odds of ICH. Further studies are needed to confirm this association.e.
Alobaida, M; Abdul-Rahim, A. (2023). 642 Impact of bridging therapy vs endovascular thrombectomy alone on outcomes in anticoagulated patients with atrial fibrillation presenting with mild-moderate ischaemic stroke. European Stroke Journal. 8(Suppl 2), pp.102-103. [Online]. Available at: https://journals.sagepub.com/doi/10.1177/23969873231169660 [Accessed 30 October 2023]
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