Cardiac thrombi detected by CT in patients with acute ischemic stroke: A substudy of Mind the Heart

摘要

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: Among 452 included patients, cardiac CT detected 41 thrombi in 38 (8) patients. Thrombi were most often located in the left atrial appendage (31/38 82). Patients with a cardiac thrombus more frequently had intracranial occlusions in multiple vascular territories (5 vs 0.5, p ?=?0.04) and a higher baseline NIHSS score (17 IQR 6–22 vs 5 IQR 2–3, p ?