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Cardiac thrombi detected by CT in patients with acute ischemic stroke: A substudy of Mind the Heart.
Rinkel, Leon A; Beemsterboer, Chiel Fp; Groeneveld, Nina-Suzanne; Lobé, Nick Hj; Boekholdt, S Matthijs; Bouma, Berto J; Muller, Fenna F; Beenen, Ludo Fm; Marquering, Henk A; Majoie, Charles Blm; Roos, Yvo Bwem; van Randen, Adrienne; Planken, R Nils; Coutinho, Jonathan M.
Afiliación
  • Rinkel LA; Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Beemsterboer CF; Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Groeneveld NS; Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Lobé NH; Departments of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Boekholdt SM; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Bouma BJ; Department of Cardiology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Muller FF; Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Beenen LF; Departments of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Marquering HA; Departments of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Majoie CB; Departments of Biomedical Engineering and Physics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Roos YB; Departments of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • van Randen A; Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Planken RN; Departments of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
  • Coutinho JM; Departments of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Eur Stroke J ; 8(1): 168-174, 2023 03.
Article en En | MEDLINE | ID: mdl-37021199
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 < 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombosis / Apéndice Atrial / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Eur Stroke J Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombosis / Apéndice Atrial / Accidente Cerebrovascular / Accidente Cerebrovascular Isquémico Tipo de estudio: Guideline / Observational_studies / Risk_factors_studies Límite: Adult / Humans Idioma: En Revista: Eur Stroke J Año: 2023 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Reino Unido