Synapse
⌘+K
Synapse
PulseExploreClubsResearchersJournals
Instagram
HomeClubsExplore
October 26, 2022European Stroke JournalOpen Access

CT-detected cardiac thrombus in acute ischemic stroke is linked to ~218% higher odds of worse 90-day outcomes.

View Full Paper
Ask AI
Bookmark
Share

Why the study?

Cardiac thrombi are a major risk factor for ischemic stroke but are rarely diagnosed in the acute phase.

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?

Population

Consecutive adult patients with acute ischemic stroke undergoing acute prospective ECG-gated cardiac CT

Comparison

Patients with a cardiac thrombus on CT vs those without

Design

Prospective cohort substudy

Follow-up

90 days

Key result

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).

Authors

LRLeon A. RinkelCBChiel F.P. BeemsterboerNGNina-Suzanne Groeneveld

Discussion

Loading...

Member takes

Overview

Cardiac thrombus on acute CT identifies higher-risk ischemic stroke patients; leaves open whether detection should alter antithrombotic management.

Study Design

Type

Cohort (n=452)

Multicenter

No

Structured PICO

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?

P
Population
Consecutive adult patients with acute ischemic stroke undergoing prospective ECG-gated cardiac CT during their acute stroke imaging protocol
I
Intervention
Presence of a cardiac thrombus on CT (defined as filling defect <100 Hounsfield Units)
C
Comparator
Absence of a cardiac thrombus on CT
O
Outcome
Functional outcome (modified Rankin scale) at 90 dayshard clinical

Main Result

Effect estimate: aOR 3.18 (95% CI 1.68-6.00)

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.

Limitations

  • Single center study, which limits the generalizability of the results
  • Limited sample size, leaving the study underpowered to detect a difference in risk of recurrent stroke
  • Did not perform transesophageal echocardiography (TEE) in patients with cardiac thrombus to confirm the diagnosis
  • Lack of objective markers (e.g., laboratory parameters) to determine subtherapeutic levels of DOACs at baseline

Cite This Study

Rinkel et al. (2022) 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).

synapsesocial.com/papers/6a086b4e9a6c4ba6e6109dc5https://doi.org/10.1177/23969873221130838
View Full Paper
Ask AI
Bookmark
Share