TY - JOUR T1 - Predictors and clinical impact of infarct progression rate in the ESCAPE-NA1 trial JF - Journal of NeuroInterventional Surgery JO - J NeuroIntervent Surg SP - 886 LP - 891 DO - 10.1136/neurintsurg-2021-017994 VL - 14 IS - 9 AU - Johanna Maria Ospel AU - Rosalie McDonough AU - Andrew M Demchuk AU - Bijoy K Menon AU - Mohammed A Almekhlafi AU - Raul G Nogueira AU - Ryan A McTaggart AU - Alexandre Y Poppe AU - Brian H Buck AU - Daniel Roy AU - Diogo C Haussen AU - René Chapot AU - Thalia S Field AU - Mahesh V Jayaraman AU - Michael Tymianski AU - Michael D Hill AU - Mayank Goyal A2 - , Y1 - 2022/09/01 UR - http://jnis.bmj.com/content/14/9/886.abstract N2 - 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. ER -