Evidence map›Paper›PMID 40681802›Full record

ArticleJournal of thrombosis and thrombolysis2026

Atrial cardiopathy and thrombus composition in acute ischemic stroke: histological examination reveals insights into etiology and outcomes.

Yixin Zhao, Jie Lian, Meng Wei, Wanying Chen, Guanjun Zhang, Guogang Luo, Fude Liu

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Article in Journal of thrombosis and thrombolysis, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Yixin Zhao *Stroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, China.
Jie Lian *Pathology Department, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, China.
Meng WeiStroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, China.
Wanying ChenStroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, China.
Guanjun ZhangPathology Department, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, China.
Guogang LuoStroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, China. lguogang@163.com.
Fude LiuStroke Centre, Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, China. liufude101@163.com.

Funding

the Key Research and Development Plan of Shaanxi Province 2021SF-059
6 · The paper itself

Abstract

introductionIn a subset of acute ischemic stroke (AIS) patients, particularly those with large-artery atherosclerosis (LAA) and atrial cardiopathy, multiple embolic sources may coexist. Histological analysis of thrombi presents an opportunity for discerning insights into both etiology and prognosis.

methodsIn our investigation, we meticulously examined 97 retrieved thrombi through histological staining and immunohistological techniques.

resultsThrombi originating from patients diagnosed with atrial fibrillation (AF) (n = 43) presented notably elevated levels of fibrin (54.16 ± 18.57% vs. 36.07 ± 18.23%, P < 0.001) and neutrophil extracellular traps (NETs) [13.21 (9.42, 15.36)% vs. 7.96 (4.98, 15.13)%, P = 0.01], alongside reduced red blood cell content (35.09 ± 16.74% vs. 51.58 ± 19.67%, P < 0.001). Within the subgroup of AIS patients with LAA, those presenting with atrial cardiopathy (n = 29) presented higher platelet levels within the thrombus (12.44 (7.59, 19.25)% vs. 8.90 (0.60, 12.37)%, P = 0.04), with the association remaining significant after generalized linear model (GLM) adjustments (P = 0.004). Notably, NETs identified within the thrombus emerged as an independent prognostic indicator for poor outcomes, defined as the modified Rankin scale (mRS) score > 2 at 90 days (OR: 1.12, 95% CI: 1.02-1.25; P = 0.02).

conclusionsThese observations provide histopathological evidence supporting the presence of overlapping mechanisms contributing to thromboembolism that are potentially associated with underlying atrial cardiopathy. Consequently, histopathological evaluation of thrombi holds promise as a valuable tool for distinguishing between various etiologies and predicting clinical outcomes in AIS patients.

Indexed as

Atrial FibrillationHeart DiseasesIschemic StrokeThrombosisAgedAged, 80 and overExtracellular TrapsFemaleFibrinHeart AtriaHumansMaleMiddle AgedPrognosisFibrinAcute ischemic strokeImmunohistochemistryMechanical thrombectomyNeutrophil extracellular trapsThromboembolism

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