| Title: |
Abstract A029: Diagnostic Yield of Cardiac CT to Detect Cardiac Thrombi in Acute Ischemic Stroke: an Individual Patient Data Meta-Analysis. |
| Authors: |
Nio, Shan Sui; Green, Daniel; Berry-Noronha, Alexander; Rinkel, Leon; Beemsterboer, Chiel; Hasnain, Md Golam; Planken, R. Nils; van Randen, Adrienne; Hilt, Mirre; Ruhe, Deborah; Bouma, Berto; Boekholdt, S; Chew, Beng Lim Alvin; Fridgant, Joshua; MENA ROMO, LUIS; Kim, Dong Hyun; Guo, Shuyu; Alamri, Yassar; Winders, Joel; Senadeera, Sajith; Lim, Anthony; Fink, John; Leung, Melissa; Cordato, Dennis; Parsons, Mark; Spratt, Neil; Garcia-Esperon, Carlos; Wu, Teddy; Coutinho, Jonathan |
| Source: |
Stroke ; volume 57, issue Suppl_1 ; ISSN 0039-2499 1524-4628 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2026 |
| Description: |
Background: Cardiac CT acquired during the acute stroke imaging protocol is an emerging diagnostic modality to detect cardiac thrombi. We aimed to determine its diagnostic yield in a large, international, multicenter study. Methods: We performed an individual patient data meta-analysis by pooling prospective and retrospective observational data of patients with acute ischemic stroke (AIS) who underwent cardiac CT (ECG-gated or non-ECG-gated) as part of the acute imaging protocol between May 2018 and June 2024. We excluded patients with a TIA or stroke mimic. The primary outcome was the proportion of patients with a cardiac thrombus detected on cardiac CT. Secondary outcomes were additional scan time and radiation dose, comparison of yield with echocardiography, and 90-day mortality and recurrent ischemic stroke rates. Results: We included 3940 patients from 4 hospitals (median age 74 [IQR 63-82], 58.0% male, median NIHSS 6 [IQR 3-12], median time onset to hospital arrival 100 minutes [IQR 62-185]). Atrial fibrillation at baseline was present in 23.1% patients, and 29.6% had a large vessel occlusion. Cardiac CT was non-diagnostic in 17 (0.4%) patients. In total, cardiac CT detected 254 cardiac thrombi in 243/3923 (6.2%) patients. Thrombi were located in the left atrial appendage (n=193), left atrium (n=19), and left ventricle (n=42). Of 95/243 (39.1%) patients with a cardiac thrombus that underwent echocardiography (median interval cardiac CT-echocardiography: 2 days), transthoracic echocardiography detected a thrombus in 18/92 (19.6%) patients and transesophageal echocardiography in 2/5 (40.0%) patients. The diagnostic yield in patients that underwent both modalities was higher for cardiac CT (OR 7.5 [CI 4.0-15.3], p |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1161/str.57.suppl_1.a029 |
| Availability: |
https://doi.org/10.1161/str.57.suppl_1.a029 |
| Accession Number: |
edsbas.35037176 |
| Database: |
BASE |