Abstract
Introduction:
Previous research reported higher prevalence of vascular risk factors and worse outcomes after stroke in non-white patients compared to whites. Whether similar results still apply in the post mechanical thrombectomy era remains unknown.
Methods:
The STAR registry combined the prospectively maintained databases of 11 thrombectomy-capable stroke centers in the US, Europe, and Asia. Consecutive patients who underwent MT were included in these analyses. Baseline features, risk factors, location of occlusion, time from symptom onset, tPA receipt, procedural complication rates, symptomatic hemorrhage, and long-term functional outcome were compared between white and non-white patients. Multivariate logistic regression analysis was performed to evaluate the impact of race on long-term outcome.
Results:
Total of 2,284 patients were included in this analysis. Of those, 1,436 (62.9%) were white. Baseline features and outcomes are summarized in table 1. Non-white patients were older ( 71 Vs 66, p=<0.001), more likely to be female ( 53.1% Vs 48.5%, p=0.034), had lower NIHSS on admission ( 15 Vs 16, p=<0.001), higher prevalence of hypertension, hyperlipidemia, diabetes, lower incidence of atrial fibrillation, higher rate of tPA receipt, shorter onset to groin access times, and longer procedural times. White patients had higher rates of successful revascularization (77.4% Vs 72.3%, p=0.006) and longer hospital stay. On multivariate logistic regression analysis, white race was an independent predictor of good 90-day outcome (OR 1.35, 95% CI 1.03-1.76, P=0.031) after controlling for age, sex, location of occlusion, IV-tPA, ASPECT score, procedure duration and final TICI score.
Conclusion:
In this study, white race was independent predictor of good 90-day outcome. This finding could be due to higher prevalence of vascular risk factors in non-white patients.