Why the study?
Cardiac CT during acute stroke imaging is an emerging modality to detect cardiac thrombi, but its yield in patients with acute ischemic stroke needed to be determined.
Does cardiac CT acquired during the acute stroke imaging protocol effectively detect cardiac thrombi in patients with acute ischemic stroke?
Population
Patients with acute ischemic stroke undergoing ECG-gated or non-ECG-gated cardiac CT across 4 prospective cohorts
Comparison
Cardiac CT detection of thrombus vs transthoracic echocardiography and outcomes in patients with vs without thrombus
Design
1-stage individual patient data meta-analysis of 4 prospective observational cohorts
Follow-up
90 days
Key result
Cardiac thrombi detected on cardiac CT in acute ischemic stroke patients (≈6% prevalence) were associated with higher 90-day mortality (33% vs 15%; aOR 1.6, 95% CI 1.1-2.3).
Authors
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May flag higher-risk patients for closer monitoring; leaves open whether routine cardiac CT integration improves outcomes.
Meta-Analysis
Yes
Does cardiac CT acquired during the acute stroke imaging protocol effectively detect cardiac thrombi in patients with acute ischemic stroke?
Integrating cardiac CT into acute stroke imaging protocols is feasible, provides a higher diagnostic yield for cardiac thrombi than transthoracic echocardiography, and identifies patients at higher risk of 90-day mortality.
Nio et al. (2026) conducted a meta-analysis in Acute ischemic stroke. Cardiac thrombus detected on cardiac CT vs. No cardiac thrombus was evaluated on Proportion of patients with a thrombus on cardiac CT. Cardiac thrombi detected on cardiac CT in acute ischemic stroke patients (≈6% prevalence) were associated with higher 90-day mortality (33% vs 15%; aOR 1.6, 95% CI 1.1-2.3).
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