Cardiac CT for Patients with Acute Ischemic Stroke

Clinical Takeaway

: CT detected substantially more cardiac thrombi than TTE.

Context

Transthoracic echocardiography (TTE) is often used after acute ischemic stroke to investigate potential embolic sources, such as left ventricular thrombi and endocarditis. However, cardiac CT provides better visualization of the left atrium, making it a promising alternative.

To learn more, researchers pooled individual patient data from four prospective cohort studies involving 3900 patients with acute stroke (median age, 74). All underwent cardiac CT during acute stroke imaging; 1300 also underwent TTE a median of 9 days later.

Key Results

6% of patients had a thrombus detected with CT (5% atrial, 1% ventricular).
In the group that underwent both tests, cardiac CT detected thrombi more often than TTE (7% vs. 2%).
In 89% of patients with…

Reviewing Author

Seemant Chaturvedi, M.D.

Disclosures

Consultant/Advisory BoardBayer Pharmaceuticals; Novartis

Grant/Research SupportNational Institute of Neurological Disorders and Stroke

Editorial BoardsNeurology; Stroke