Abstract WP150: Influence Of Body Mass Index On Adenosine Deaminase And Infarct Volume In Mechanical Thrombectomy Subjects

Background: Emergent Large Vessel Occlusion (ELVO) strokes are devastating ischemic vascular events for which novel biomarkers and therapies are needed. The purpose of this study is to investigate the role of Body Mass Index (BMI) on protein expression and signaling at the time of ELVO intervention. Methods: The Blood And Clot Thrombectomy Registry And Collaboration (BACTRAC) is a continually enrolling tissue bank (clinicaltrials.gov NCT03153683) from stroke patients undergoing mechanical thrombectomy (MT). N=61 human carotid plasma samples were analyzed for inflammatory and cardiometabolic protein expression by Olink Proteomics. Results: The 61 subjects studied were broken into three categories: Normal weight (BMI 18.5-24.9) which contained 19 subjects, Overweight (BMI 25-30) which contained 25 subjects, and Obese (BMI ≥30) which contained 17 subjects. When compared to Normal weight and Overweight categories, the Obese category had significantly higher levels of adenosine deaminase (ADA) expression (p=0.01 and p=0.039, respectively). Elevated levels of ADA were found to have a significant positive correlation with both infarct volume and edema volume (p=0.013 and p=0.041, respectively), and were associated with a more severe stroke (NIHSS on discharge) and greater stroke-related disability (mRS on discharge) with significance of p=0.053 and p=0.032, respectively). When controlling for age and sex, increased infarct volumes were predicted by higher ADA levels in the Obese population (p=0.009), while increased ADA levels were not predictive of increased infarct volumes in the Normal weight category. Conclusions: When examined according to BMI, subjects undergoing MT for ELVO demonstrate significant differences in the expression of certain plasma proteins including ADA. The protein ADA is a deaminating enzyme that degrades adenosine, which has been shown to be neuroprotective in ischemia. Increased levels of ADA in the Obese group were predictive of increased infarct volumes. Further testing will explore the relationship of BMI and ADA on cognitive function outcomes. These data provide novel biomarker candidates as well as treatment targets while increasing the personalization of stroke prognosis and treatment.