Why the study?
Cardiac CT during acute stroke imaging is an emerging modality to detect cardiac thrombi, but its diagnostic yield needed determination in a large, international, multicenter study.
Does cardiac CT improve the detection of cardiac thrombi compared to echocardiography in patients with acute ischemic stroke?
Population
3940 patients with acute ischemic stroke from 4 hospitals
Comparison
Cardiac CT vs echocardiography
Design
Individual patient data meta-analysis of prospective and retrospective observational data
Follow-up
90-day
Key result
Cardiac CT during the acute stroke imaging protocol detected cardiac thrombi in 6.2% of patients, with a higher diagnostic yield than echocardiography (OR 7.5; 95% CI 4.0-15.3; P<0.001).
Authors
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May enhance thrombus detection in acute ischemic stroke; extends observational data but leaves clinical impact and practice change open.
Meta-Analysis (n=3,940)
Yes
Does cardiac CT improve the detection of cardiac thrombi compared to echocardiography in patients with acute ischemic stroke?
Routine cardiac CT during acute stroke imaging provides a 7-times higher diagnostic yield for detecting cardiac thrombi compared to routine echocardiography.
Nio et al. (2026) conducted a meta-analysis in acute ischemic stroke (AIS) (n=3,940). Cardiac CT vs. Echocardiography was evaluated on proportion of patients with a cardiac thrombus detected on cardiac CT. Cardiac CT during the acute stroke imaging protocol detected cardiac thrombi in 6.2% of patients, with a higher diagnostic yield than echocardiography (OR 7.5; 95% CI 4.0-15.3; P<0.001).