Abstract TP152: Association Of 24-hour Blood Pressure Parameters Post-thrombectomy With Functional Outcomes In Anemic And Non-Anemic Patients

Introduction: Higher blood pressure (BP) is thought to be detrimental in patients who undergo mechanical thrombectomy (MT), however, the impact of BP post-MT based on comorbidities like anemia has not been well studied. We aim to determine the association of 24-h post-MT BP parameters with clinical outcomes depending on the presenting anemia status. Methods: We conducted a retrospective chart review of patients who underwent MT at a comprehensive stroke center from 7/2014 to 12/2020. Patients were dichotomized into anemic and non-anemic groups based on the World Health Organization’s definition of anemia [hemoglobin <12.0 g/dL in women and <13.0 g/dL in men]. We performed a binary logistic regression analysis controlling for baseline parameters, with the 24-h post-MT BP parameters as predictors. The outcome was functional dependence (3-month mRS ≥2). Results: 220 patients met the inclusion criteria. 158 (71.82%) patients had functional dependence at 3-months. In the multivariable analysis, the parameters of a higher mean SBP (132.9±11.94 vs.126.52±13.3; OR, 1.04; 95% CI, 1.01-1.08; P 0.043), a higher maximum SBP (159.05±13.43 vs153.11±19.07; OR, 1.04; 95% CI, 1.01-1.07; P 0.04) and a higher maximum MAP (115.26±11.73 vs.109.37±12.51; OR, 1.04; 95% CI, 1.01-1.08; P 0.042) were significantly associated with functional dependence in patients without anemia. For patients with anemia, there was no association between 24-hour BP Parameters post-MT and functional dependence. Conclusion: In our study, higher BP parameters were associated with worse outcomes in patients without anemia, however, this effect was not found in patients with anemia. Anemia induces a relative hypoxic state in target tissue in the event of an increase in metabolic demand such as stroke. Higher BP post-MT can potentially promote perfusion and thus is not associated with worse outcomes in anemic patients post-MT, whereas in non-anemic patients it potentially leads to reperfusion injury.