Key result
Spontaneous echo contrast is linked to a ~9-fold higher risk of LAA thrombus in stroke.
Why the study?
No consensus exists about the use of imaging strategies to identify potential cardiovascular sources of emboli in patients who have had strokes.
Population
Hypothetical patients with a first stroke in normal sinus rhythm
Comparison
Nine diagnostic strategies including transthoracic echocardiography, transesophageal echocardiography, sequential approaches, selective imaging, and no imaging
Design
Markov model decision analysis
Authors
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May inform TEE use for thrombus risk in sinus-rhythm stroke; leaves open whether screening changes anticoagulation or outcomes.
Cross-Sectional (n=223)
No
Odds Ratio: 9.04 (95% CI 2.12–38.54)
p-value: p=0.003
Robert L. McNamara (1997) conducted a cross-sectional in Acute ischemic stroke with sinus rhythm (n=223). Spontaneous echo contrast (SEC) vs. Absence of SEC was evaluated on Presence of left atrial appendage (LAA) thrombus (OR 9.04, 95% CI 2.12 to 38.54, p=0.003). In patients with acute ischemic stroke and sinus rhythm, the presence of spontaneous echo contrast on transesophageal echocardiography was significantly associated with left atrial appendage thrombus (OR 9.04).
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