{
  "abstract": "Introduction Endovascular thrombectomy (EVT) improves outcomes in large-vessel acute ischemic stroke, yet hemorrhagic transformation (HT) remains a serious threat. Many patients receive chronic anticoagulation for non-valvular atrial fibrillation (NVAF), raising concern that baseline therapy could heighten HT risk. We assessed whether pre-stroke anticoagulation independently predicts HT after EVT.Methodology We retrospectively reviewed 317 consecutive patients treated at a comprehensive stroke center (December 2019-January 2022). Baseline anticoagulation status and NVAF history were recorded. Demographic, clinical, laboratory, and imaging data were extracted; HT was classified by ECASS III. Analysis focused on those who underwent EVT. Fisher exact test with odds ratios (OR) evaluated the anticoagulation-HT association (α = 0.05).Results The cohort was 55.8 % male, median age 68 y (27-99), mean BMI 27.9 kg m-2. Hypertension, hyperlipidemia, diabetes, coronary disease/MI, prior stroke/TIA, and atrial fibrillation occurred in 76.6, 68.5, 38.2, 26.5, 25.2, and 18 % respectively. Baseline therapy: antiplatelet 24.3 %, anticoagulant 11.3 %, both 12.3 %, neither 52.1 %. Mean values were NIHSS 8, ASPECTS 9, SBP 154 mmHg, glucose 152 mg dL-1, platelets 251 × 10(9)L-1. Occlusions most often involved M1 (16.7 %) and internal carotid (12 %). EVT was performed in 110 patients (34.7) and IV thrombolysis in 128 (40.4). Adverse events: intracranial hemorrhage 24, GI bleeding 6, hospice 1, in-hospital death 13. Among 36 anticoagulated patients, 20 had NVAF and 11 underwent EVT; one developed HT (OR 0.70, p = 1.00). Among 242 non-anticoagulated patients, 9 had NVAF and 72 underwent EVT; nine developed HT (OR 1.11, p = 1.00). HT risk did not differ significantly.Conclusion In this single-center retrospective study, baseline anticoagulation for NVAF was not linked to increased HT after EVT. Findings suggest chronic anticoagulation may not independently raise post-EVT bleeding risk. Retrospective design, single site, and a small anticoagulated subgroup limit generalizability; larger prospective multicenter studies are needed to confirm safety and guide individualized EVT protocols.Disclosures S. Vyas: None. S. Scarpiello: None. J. Haimi: None. Z. Singh: None. B. Percival: None. S. Nageeb: None. S. Bozkurt: None. I. Abualnadi: None. U. Panchal: None. P. Sharma: None. H. Zacharatos: None. B. Jankowitz: None.",
  "authors": [
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "S Vyas"
    },
    {
      "affiliations": [
        "JFK University Medical Center - Hackensack Meridian Health, Edison, NJ"
      ],
      "name": "T Snyder"
    },
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "S Scarpiello"
    },
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "J Haimi"
    },
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "Z Singh"
    },
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "B Percival"
    },
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "S Nageeb"
    },
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "S Bozkurt"
    },
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "I Abualnadi"
    },
    {
      "affiliations": [
        "Department of Computer Science, University of California, Davis, CA"
      ],
      "name": "U Panchal"
    },
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "P Sharma"
    },
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "H Zacharatos"
    },
    {
      "affiliations": [
        "Neuroscience, Hackensack Meridian Health JFK University Medical Center, Edison, NJ"
      ],
      "name": "B Jankowitz"
    }
  ],
  "title": "E-096 Baseline anticoagulation in non-valvular atrial fibrillation does not increase hemorrhagic transformation risk after endovascular thrombectomy",
  "uid": "676c5e35-12b7-5e95-903e-79fe7ab72504"
}