RT Journal Article SR Electronic T1 Predictors and clinical impact of infarct progression rate in the ESCAPE-NA1 trial JF Journal of NeuroInterventional Surgery JO J NeuroIntervent Surg FD BMJ Publishing Group Ltd. SP 886 OP 891 DO 10.1136/neurintsurg-2021-017994 VO 14 IS 9 A1 Johanna Maria Ospel A1 Rosalie McDonough A1 Andrew M Demchuk A1 Bijoy K Menon A1 Mohammed A Almekhlafi A1 Raul G Nogueira A1 Ryan A McTaggart A1 Alexandre Y Poppe A1 Brian H Buck A1 Daniel Roy A1 Diogo C Haussen A1 René Chapot A1 Thalia S Field A1 Mahesh V Jayaraman A1 Michael Tymianski A1 Michael D Hill A1 Mayank Goyal A1 , YR 2022 UL http://jnis.bmj.com/content/14/9/886.abstract AB Background Determining infarct progression rate in acute ischemic stroke (AIS) is important for patient triage, treatment decision-making, and outcome prognostication.Objective To estimate infarct progression rate in patients with AIS with large vessel occlusion (LVO) and determine its predictors and impact on clinical outcome.Methods Data are from the ESCAPE-NA1 Trial. Patients with AIS with time from last known well to randomization <6 hours and near-complete reperfusion following endovascular treatment were included. Infarct growth rate (mL/h) was estimated by dividing 24 hour infarct volume (measured by non-contrast CT or diffusion-weighted magnetic resonance imaging) by time from last known well to reperfusion. Multivariable linear regression was used to assess the association of patient baseline variables with log-transformed infarct progression rate. The association of infarct progression rate and good outcome (modified Rankin Scale score 0–2) was determined using multivariable logistic regression.Results Four hundred and nine patients were included in the study. Median infarct progression rate was 4.74 mL/h (IQR 1.25–14.84). Collateral status (β: −0.81 (95% CI −1.20 to −0.41)), Alberta Stroke Program Early CT Score (ASPECTS, β: −0.34 (95% CI −0.46 to −0.23)), blood glucose(β: 0.09 (95% CI 0.02 to 0.16)), and National Institutes of Health Stroke Scale (NIHS score (β: 0.07 (95% CI 0.04 to 0.10)) were associated with log-transformed infarct progression rate. Clinical and imaging baseline variables explained 23% of the variance in infarct progression rate. Infarct progression rate was significantly associated with good outcome (aOR per 1 mL/h increase: 0.96 (95% CI 0.95 to 0.98)).Conclusion In this sample of patients presenting within the early time window with LVO and near-complete recanalization, infarct progression rate was significantly associated with good outcome. A significant association between ASPECTS, collateral status, blood glucose, and NIHSS score was observed, but baseline imaging and clinical characteristics explained only a small proportion of the interindividual variance. More research on measurable factors affecting infarct growth is needed.All data relevant to the study are included in the article or uploaded as supplementary information. The data underlying this research will be made available by the corresponding author upon reasonable request and after approval by the ESCAPE-NA1 investigator committee.