The presence of a cardiac thrombus detected on CT in patients with acute ischemic stroke was associated with a significantly worse functional outcome at 90 days (aOR 3.18).
Cohort (n=452)
No
Does the presence of a cardiac thrombus detected by acute-phase cardiac CT worsen functional outcome or increase stroke recurrence in patients with acute ischemic stroke?
In patients with acute ischemic stroke, the presence of a cardiac thrombus detected by acute-phase cardiac CT is associated with more severe deficits and worse functional outcomes at 90 days.
Effect estimate: aOR 3.18 (95% CI 1.68-6.00)
Background: Cardiac thrombi are a major risk factor for ischemic stroke, but are rarely diagnosed in the acute phase. We examined characteristics and functional outcome of patients with ischemic stroke and a concomitant cardiac thrombus detected on cardiac CT performed in the acute phase. Patients and Methods: We used data from "Mind the Heart," a prospective cohort study in which consecutive adult patients with acute ischemic stroke underwent prospective ECG-gated cardiac CT during their acute stroke imaging protocol. We compared characteristics, functional outcome (modified Rankin scale) and stroke recurrence rate at 90 days of patients with a cardiac thrombus on CT (defined as filling defect <100 Hounsfield Units) to those without a cardiac thrombus. Results: < 0.001) compared to patients without a cardiac thrombus. In 13/38 (34%) patients with a cardiac thrombus, no atrial fibrillation was detected. A cardiac thrombus was associated with worse functional outcome (adjusted common odds ratio 3.18 95%CI 1.68-6.00). Recurrence rate was not significantly different (8% vs 4%, aOR 1.50 (0.39-5.82). Discussion and Conclusion: Cardiac CT detected a cardiac thrombus in one in every 12 patients with acute ischemic stroke, and these patients had more severe deficits, multivessel occlusions, and a worse functional outcome.
Rinkel et al. (Wed,) conducted a cohort in Acute ischemic stroke (n=452). Presence of cardiac thrombus on CT vs. Absence of cardiac thrombus on CT was evaluated on Worse functional outcome (shift on modified Rankin Scale at 90 days) (aOR 3.18, 95% CI 1.68-6.00). The presence of a cardiac thrombus detected on CT in patients with acute ischemic stroke was associated with a significantly worse functional outcome at 90 days (aOR 3.18).