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Abstract 1122‐000220: Analysis of Protein Network to Predict Cognition Among Emergent Large Vessel Occlusion Undergoing Mechanical Thrombectomy


 Introduction
 : Emergent Large Vessel Occlusion (ELVO) strokes are devastating ischemic vascular events that can cause severe and permanent impairment. The purpose of the current study is to investigate interactions among different proteins at the time of mechanical thrombectomy (MT) which correlates to Montreal Cognitive Assessment (MOCA) scores at discharge and at 90‐day follow‐up.
 
 
 Methods
 : The Blood And Clot Thrombectomy Registry And Collaboration (BACTRAC) study is a continually enrolling tissue bank (clinicaltrials.gov NCT03153683) and registry from stroke patients undergoing mechanical thrombectomy. Blood samples from systemic arterial blood (internal carotid artery) of twenty‐three patients were collected and sent to Olink Proteomics (Olink Proteomics, Boston, Massachusetts, USA) for analysis of protein expression of 92 cardiometabolic proteins and 92 inflammatory proteins. To determine which proteins had the most significant changes based on MOCA scoring, a series of 184 paired t‐tests were performed. Within each panel, proteins were then ranked based on the associated p values. Benjamini and Hochberg’s linear step‐up procedure was used to control the false discovery rate at 0.05. Pearson Correlation revealed proteins that were significantly related to the patients’ s discharge MOCA score as well as 90‐day follow‐up MOCA. Data and network analyses were performed using IBM SPSS Statistics, SAS v 9.4, and STRING V11. Common proteins between the discharge day miniMoCA and 90 days MOCA were identified. Network of these protein associations was created and biological processes correlating with these networks were identified.
 
 
 Results
 : Twenty‐two patients (15 with discharge day MiniMOCA and 7 with 90 days MOCA) were included in the analysis. Of these patients, 14 were females, and 9 were obese (BMI>30). 2 had minor stroke (NIHSS: 1–4), 13 had moderate stroke at admission (NIHSS: 5–15), 4 had moderate to severe stroke (NIHSS: 16–20), and 2 patients had severe stroke (NIHSS > 21). 19 patients had associated comorbidities (hypertension, diabetes, and hyperlipidemia). Mean last known normal to thrombectomy completion time was 621 + 333 minutes and mean infarct volume was 18,271 + 16,534 mm3. The 9 overlapping proteins from discharge to 90‐day follow up were later analyzed using interconnected STRING to determine association network and proteomic biological functions. Nine proteins include: DPP4, NCAM1, TGFBI, PRCP, APOM, TIE1, QPCT, MEGF9, and IGFBP3. Biological processes relating to the network of 9 proteins are depicted in table 1.
 
 
 Conclusions
 : This study uncovers network proteins that play a significant role in cognitive outcomes following ischemic stroke. This will allow future studies to develop predictive biomarkers for treatment and proteomic targets for adjunctive therapies to thrombectomy to improve our ability to treat cognitive dysfunction in ELVO stroke patients.
