Diagnostic Yield of Cardiac CT to Detect Cardiac Thrombi in Acute Ischemic Stroke: an Individual Patient Data Meta-Analysis (AIS of HEARTS)

Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)

Status: Completed

Conditions: Ischemic Stroke; Cardioembolic Stroke; Cardiac CT; Thrombus

Study type: Observational

Funder types: Other

Identifiers

NCT07165093

NL64139.018.18

Details and patient eligibility

About

The aim of the AIS of HEARTS registry is to establish a database to collect, maintain and provide accessible individual patient data from international cohorts and to provide pooled analyses about the yield and value of cardiac computed tomography (CT), acquired during the initial stroke imaging protocol.

The main analysis will investigate the diagnostic yield of cardiac CT to detect cardioembolic sources of stroke in acute ischemic stroke patients.

Full description

This study is an individual patient data meta-analysis of four different cohorts (4 hospitals) with both prospective and retrospective data. Patients are included if they underwent cardiac CT (ECG gated or non-ECG gated) acquired during the acute stroke scan protocol. The main paper will focus on the diagnostic yield of cardiac thrombi detected on cardiac CT acquired during the acute stroke scan protocol, the comparison with echocardiography and the 90 day follow-up outcomes.

Prospectively planned subanalyses from the AIS of HEARTS registry:

Beyond the analyses focussed on cardiac thrombi, the investigators have prespecified the following analyses:

• Risk stratification of cardioembolic sources in acute ischemic stroke to improve decision making in performing a cardiac CT
• Short term clinical implications of cardiac thrombi detected on cardiac CT
• Long term clinical implications of cardiac thrombi detected on cardiac CT
• Diagnostic yield of ECG-gated versus non-ECG-gated cardiac CT in the acute phase of ischemic stroke
• Association between left atrial appendage contrast filling characteristics and recurrent stroke
• Association between left atrial appendage (LAA) morphology/volume and LAA thrombus
• Cardiac thrombus and associations with medium vessel occlusions strokes
• High-risk cardioembolic sources on cardiac CT in TIA patients
• Clinical relevance of valvular vegetations detected on cardiac CT
• Long term clinical implications of left atrial diverticula detected on cardiac CT
• Incidental findings on cardiac CT The investigators are planning to perform these additional analyses once the main paper has been accepted/submitted.

Enrollment: 3,940 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age 18 years or older
• Clinical diagnosis of acute ischemic stroke
• Cardiac CT acquired during acute stroke scan protocol

Exclusion criteria

• Transient ischemic attack
• Stroke mimics

Trial design

3,940 participants in 4 patient groups

Amsterdam UMC

Description:

Patients from Amsterdam UMC that underwent ECG-gated cardiac CT

Christchurch Hospital

Description:

Patients from Christchurch hospital that underwent non-ECG gated cardiac CT

John Hunter Hospital

Description:

Patients from John Hunter Hospital that underwent non-ECG gated cardiac CT

Liverpool Hospital

Description:

Patients from Liverpool Hospital that underwent ECG-gated cardiac CT