Association of biological age acceleration with poor outcome after endovascular thrombectomy

Accelerated aging is recognized as a risk factor for various chronic diseases and mortality. This study aimed to utilize phenotypic age to evaluate the role of biological age in clinical outcomes in ischemic stroke patients after endovascular thrombectomy (EVT).

We retrospectively enrolled patients from the prospectively maintained stroke registry admitted at 2 stroke centers in China. We employed the widely recognized PhenoAge algorithms to calculate accelerated biological age. Poor outcome was defined by a modified Rankin Scale score > 2 at 90 days post-treatment. Multivariable logistic regression models were utilized to evaluate the independent impact of phenotypic age on poor outcome. The association pattern between phenotypic age and poor outcome were analyzed using restricted cubic splines.

A total of 745 patients were included with 61.5% male, a mean age of 70.1 ± 12.2 years, and a mean phenotypic age of 78.5 ± 15.1 years. In the multivariable logistic regression analysis, phenotypic age was significantly associated with 90-day poor outcome after EVT (per 1-year increase: odds ratio [OR], 1.067; 95% confidence interval [CI], 1.042-1.092; P < 0.001; fourth vs first quartile: OR, 8.295; 95% CI, 3.742-18.394; P < 0.001). Additionally, the multiple-adjusted spline regression model further confirmed the dose-response association between phenotypic age and poor outcome (P = 0.527 for nonlinearity; P = 0.001 for linearity).

This study demonstrated that phenotypic age was associated with poor outcomes in large vessel occlusive stroke patients treated with EVT. Further research is required to validate our findings in different populations.