Diagnostic Yield of Cardiac CT to Detect Cardiac Thrombi in Acute Ischemic Stroke: an Individual Patient Data Meta-Analysis
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 3,940
- 试验地点
- 1
- 主要终点
- Proportion of patients with cardiac thrombus detected on acute cardiac CT.
研究概览
简要总结
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.
详细描述
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.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Other
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Age 18 years or older
- •Clinical diagnosis of acute ischemic stroke
- •Cardiac CT acquired during acute stroke scan protocol
排除标准
- •Transient ischemic attack
- •Stroke mimics
结局指标
主要结局
Proportion of patients with cardiac thrombus detected on acute cardiac CT.
时间窗: Baseline: the assessment of a cardiac thrombus is performed when the patient arrives at the Emergency Department and undergoes the acute stroke imaging protocol including a cardiac CT.
The proportion of patients with acute ischemic stroke that have a cardiac thrombus detected on cardiac CT.
次要结局
- Comparison between cardiac CT and echocardiography for the detection of cardiac thrombi.(An average of within 1 year: we include echocardiography that is performed in routine stroke clinical care. This means that the time delay is dependent on various aspect of the local center.)
- Follow up 90 days: mortality compared between patients with and without thrombus(From stroke onset until 90 days follow-up)
- Follow-up 90 days: recurrent stroke(Stroke onset until 90 days follow-up)
- Follow-up 90 days: outcome using modified rankin scale score(Stroke onset until 90 days follow-up)
研究者
Jonathan Coutinho
Principal Investigator
Academisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)