Acute Ischemic Stroke Incidence and Characteristics After Cardiac Arrest (P7-7.005)

Objective: To describe the incidence and characteristics of acute ischemic stroke in cardiac arrest patients. Background: Brain injury is the leading cause of death and disability post-cardiac arrest, and hypoxic-ischemic brain injury (HIBI) severity is associated with poor outcomes. There is limited information about the co-occurrence of acute ischemic stroke and its impact on outcome. Design/Methods: We performed a structured MRI review of a retrospective multicenter cohort of cardiac arrest patients. We included MRIs performed within 7 days from arrest and excluded traumatic brain injury, intracranial hemorrhage, and ischemic stroke at admission. Univariate and multivariable analyses were performed to explore the characteristics of cerebral infarctions and their association with poor outcomes (i.e., Cerebral Performance Category of 3–5). Results: Among 351 included patients, 107 had cerebral infarction based on MRI (30.5%). The most common pattern of stroke is multifocal small embolic (61.7%), followed by punctate (28.9%), watershed (7.48%), territorial (6.5%), and lacunar (2.8%). The patients with acute ischemic stroke are older (p<0.01). Chronic white matter disease was associated with the occurrence of acute ischemic stroke (odds ratio [OR] 1.89 [1.11–3.25], P<0.05). In univariate and multivariable analysis, the presence of acute ischemic stroke is not associated with poor outcomes. Worse outcome is associated with older age (OR 1.05 [1.02–1.08], P<0.001) and presence of HIBI (OR 4.37 [1.9–10.5], P<0.001). Conclusions: Acute ischemic stroke is common after cardiac arrest. Acute infarctions after arrest are associated with chronic white matter disease. The most common pattern is multifocal embolic, possibly due to cardioembolism and hypercoagulable state. The impact of cerebral infarctions on cardiac arrest survivors requires deeper investigation in future longitudinal studies. Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff. Disclosure: Miss Marques has nothing to disclose. Mr. Bao has nothing to disclose. Author has nothing to discloseDr. Otero has nothing to disclose. Mr. Velasquez has nothing to disclose. Mr. Houston has nothing to disclose. Ms. Peterson has nothing to disclose. Dr. Hemphill has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Zoll. Dr. Hemphill has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for various legal firms. The institution of Dr. Hemphill has received research support from NIH/NINDS. Dr. hu has nothing to disclose. Gisele Silva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Boehringer Ingelheim. Gisele Silva has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UNIFESP/HIAE. Dr. Westover has received personal compensation in the range of $50,000-$99,999 for serving as a Consultant for Beacon Biosignals. Dr. Westover has stock in Beacon Biosignals. The institution of Dr. Westover has received research support from NIH. Dr. Westover has received publishing royalties from a publication relating to health care. Dr. Westover has a non-compensated relationship as a cofounder with Beacon Biosignals that is relevant to AAN interests or activities. The institution of Dr. Lee has received research support from NIH. The institution of Dr. Lee has received research support from NIH. The institution of Dr. Lee has received research support from UCB. Dr. Lee has received personal compensation in the range of $10,000-$49,999 for serving as a Contract work with Teladoc. The institution of Dr. Amorim has received research support from American Heart Association. The institution of Dr. Amorim has received research support from Society of Critical Care Medicine. The institution of Dr. Amorim has received research support from Zoll Foundation. The institution of Dr. Amorim has received research support from Hellman Foundation. The institution of Dr. Amorim has received research support from Regents of the University of California. The institution of Dr. Amorim has received research support from Citizens United Against Epilepsy. The institution of Dr. Amorim has received research support from Regents of the University of California. The institution of Dr. Amorim has received research support from American Heart Association. The institution of Dr. Amorim has received research support from NIH. The institution of Dr. Amorim has received research support from Department of Defense.