ITACAT study group
We performed a histological and immune analysis of the clot in acute stroke patients to determine predictors of atrial fibrillation (AF).
We conducted a prospective observational study of consecutive patients with acute stroke who underwent thrombectomy that obtained extracted thrombus (ITACAT study). Several staining were performed to evaluate red blood cells/fibrin (hematoxylin/eosin), platelets (CD61) and leucocytes (CD4, CD8 and CD20). All patients received CT angio to detect extra/intracranial vascular stenosis and 30-day cardiac monitoring to diagnose AF. Thrombi were classified in stroke due to AF (T-AF), due to symptomatic atherosclerosis (T-AT) and without any cause (T-CRYP). We excluded strokes due to double cause or incomplete workup.
Of the 215 patients: 69 were T-AT, 101 were T-AF and 45 were T-CRYP. There was no difference in percentage of hypertension, diabetics and hypercholesterolemia. Percentage of AF detection was: 3% (2/65) in T-AT, 100% (101/101) in T-AF and 40% (18/45) in T-CRYP. T-AF patients were older: T-AF 79 years (70-84) Vs. T-AT 68 years (60-76) Vs. T-CRYP 70 years (53-78) (p=0.001). T-AT group had a greater percentage of CD4: T-AT 6.76% (4-13) Vs. T-AF (3.67% (2-7) Vs.T-CRYP 4.14% (2-13) (p=0.033) and a fewer percentage of CD61: T-AT 51.33% (33-69) Vs.AF 70.62% (51-83) Vs. CRYP 69.54% (61-87) (p=0.007). The age (OR 1.47 (1.10-2) (p=0.011) and the percentage of CD4 (OR 0.83 (0.69-0.98) (p=0.034) were independently associated with AF detection. Final analysis (n=400 cases) will be ended in September 2021.
Patients with AF detection in work up had lower percentage of CD4 in extracted thrombi.
Not applicable