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Abstract Details

Is Neutrophilia a Risk Factor for Fast Stroke Progression in Large Vessel Occlusion?
Cerebrovascular Disease and Interventional Neurology
P11 - Poster Session 11 (11:45 AM-12:45 PM)

Rapid stroke progressors with large vessel occlusion (LVO) have a worse prognosis than their time-matched cohorts receiving IV thrombolytics and/or mechanical thrombectomy. To our knowledge, there are no studies that investigated neutrophilia with rapid stroke progression in the setting of LVO. 

Our objective was to evaluate the association of neutrophilia with rapid stroke progression. 


Initial white blood cell (WBC) and absolute neutrophil counts (ANC) were collected for subjects presenting with acute ischemic stroke secondary to LVO who received IV thrombolytics and/or mechanical thrombectomy within 4.5 and 6 hours, respectively. Rapid stroke progression was determined by Alberta Stroke Program Early CT Score (ASPECTS) on initial CT head. Baseline and discharge NIHSS, age, and follow up mRS were also compared to presenting WBC and ANC. Spearman’s rho was used for correlation. Social Science Statistics was used for data analysis.

From October 2020 to April 2021, the association between neutrophilia and stroke progression was evaluated in 19 subjects receiving Tenecteplase (n=16; 6 females; age, 63.25 95% CI [54.9207, 71.5793]) and Alteplase (n=4; 2 females; mean age 59, 95% CI [38.13, 79.87]) for LVO causing disabling neurological deficits. Mechanical thrombectomy was attempted in all subjects. The association between higher ANC and lower ASPECTS score reached statistical significance (rs=-0.49255, p=0.04457). There was no significant association of white blood cell (WBC) and ASPECTS score. WBC and ANC were not associated with baseline or discharge NIHSS, age, or follow up mRS.

Rapid stroke progression as measured by presenting ASPECTS score may be associated with neutrophilia. Larger prospective clinical trials are needed to validate our results

Jawad F. Kirmani, MD (RWJBarnabas Medical)
Dr. Kirmani has nothing to disclose.
Farah Y. Fourcand, MD (Cleveland Clinic Indian River) Dr. Fourcand has nothing to disclose.
Nancy Gadallah, DO (JFK Neuroscience Institute at JFK Medical Center) Dr. Gadallah has nothing to disclose.
Arifa Ghori (Hackensack Meridian Health- JFK Medical Center) Dr. Ghori has nothing to disclose.
Danisette Torres, MD (Hackensack Meridian Health- JFK Medical Center) Dr. Torres has nothing to disclose.
Abdallah O. Amireh, MD (HMH JFK Medical Center) Dr. Amireh has nothing to disclose.
Haralabos Zacharatos, MD Dr. Zacharatos has nothing to disclose.
Siddhart K. Mehta, MD Dr. Mehta has nothing to disclose.