Evidence map›Paper›PMID 42227105›Full record

SynthesisStroke2026

Diagnostic Yield of Cardiac CT to Detect Cardiac Thrombi in Patients With Acute Ischemic Stroke (AIS of HEARTS).

Shan Sui Nio, Daniel S Green, Alexander Berry-Noronha, Leon A Rinkel, Chiel F P Beemsterboer, Md Golam Hasnain, R Nils Planken, Adrienne van Randen, Sinan Al-Hadethi, Mirre G M Hilt and 21 more

Registry-linked trialAbstract readMeta-Analysis
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In one paragraph

Synthesis in Stroke, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07165093 (Diagnostic Yield of Cardiac CT to Detect Cardiac Thrombi in Acute Ischemic Stroke), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07165093 completednot on this map

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

TypeobservationalSponsorAcademisch Medisch Centrum - Universiteit van Amsterdam (AMC-UvA)Ran2018 to 2025Enrolled3,940ConditionsIschemic Stroke, Cardioembolic Stroke, Thrombus, Cardiac CT
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Shan Sui Nio *Department of Neurology (S.S.N., L.A.R., C.F.P.B., M.G.M.H., D.S.A.R., J.M.C.), Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, the Netherlands.ORCID 0000-0003-3401-7014
Daniel S Green *Department of Neurology (D.S.G., D.C., M.W.P.), School of Clinical Medicine, South Western Sydney Clinical Campus, University of New South Wales, Australia.ORCID 0000-0002-8441-6091
Alexander Berry-Noronha *Department of Neurology (A.B.-N., D.H.K., S.G., J.W., J.N.F., T.Y.W.), Christchurch Hospital, New Zealand.ORCID 0000-0003-4189-5157
Leon A RinkelDepartment of Neurology (S.S.N., L.A.R., C.F.P.B., M.G.M.H., D.S.A.R., J.M.C.), Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, the Netherlands.ORCID 0000-0002-0291-8515
Chiel F P BeemsterboerDepartment of Neurology (S.S.N., L.A.R., C.F.P.B., M.G.M.H., D.S.A.R., J.M.C.), Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, the Netherlands.ORCID 0000-0003-1665-2911
Md Golam HasnainDepartment of Neurology, School of Medicine and Public Health, University of Newcastle, Australia (M.G.H.).ORCID 0000-0002-6037-9935
R Nils PlankenDepartment of Radiology (R.N.P., A.v.R.), Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, the Netherlands.ORCID 0000-0003-3940-4670
Adrienne van RandenDepartment of Radiology (R.N.P., A.v.R.), Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, the Netherlands.ORCID 0009-0003-1753-8755
Sinan Al-HadethiDepartment of Radiology, John Hunter Hospital, Newcastle, New South Wales, Australia (S.A.-H.).ORCID 0009-0009-9431-082X
Mirre G M HiltDepartment of Neurology (S.S.N., L.A.R., C.F.P.B., M.G.M.H., D.S.A.R., J.M.C.), Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, the Netherlands.ORCID 0009-0009-6926-7233
Deborah S A RuheDepartment of Neurology (S.S.N., L.A.R., C.F.P.B., M.G.M.H., D.S.A.R., J.M.C.), Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, the Netherlands.
Berto J BoumaDepartment of Cardiology (B.J.B., S.M.B.), Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, the Netherlands.ORCID 0000-0002-1433-9692
S Matthijs BoekholdtDepartment of Cardiology (B.J.B., S.M.B.), Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, the Netherlands.ORCID 0000-0002-0861-0765
Beng Lim Alvin ChewDepartment of Neurology, John Hunter Hospital, College of Health, Medicine and Wellbeing, University of Newcastle, Australia (B.L.A.C., J.F., L.M.-R., N.J.S., C.G.-E.).
Joshua FridgantDepartment of Neurology, John Hunter Hospital, College of Health, Medicine and Wellbeing, University of Newcastle, Australia (B.L.A.C., J.F., L.M.-R., N.J.S., C.G.-E.).ORCID 0000-0002-8582-9349
Luis Mena-RomoDepartment of Neurology, John Hunter Hospital, College of Health, Medicine and Wellbeing, University of Newcastle, Australia (B.L.A.C., J.F., L.M.-R., N.J.S., C.G.-E.).ORCID 0000-0002-6874-9398
Dong Hyun KimDepartment of Neurology (A.B.-N., D.H.K., S.G., J.W., J.N.F., T.Y.W.), Christchurch Hospital, New Zealand.
Shuyu GuoDepartment of Neurology (A.B.-N., D.H.K., S.G., J.W., J.N.F., T.Y.W.), Christchurch Hospital, New Zealand.
Yassar AlamriDepartment of Medicine, University of Otago, Christchurch, New Zealand (Y.A., T.Y.W.).ORCID 0000-0003-2519-3593
Joel WindersDepartment of Neurology (A.B.-N., D.H.K., S.G., J.W., J.N.F., T.Y.W.), Christchurch Hospital, New Zealand.
Sajith C SenadeeraDepartment of Radiology (S.C.S., A.T.L.), Christchurch Hospital, New Zealand.
Anthony T LimDepartment of Radiology (S.C.S., A.T.L.), Christchurch Hospital, New Zealand.ORCID 0000-0001-6694-5398
John N FinkDepartment of Neurology (A.B.-N., D.H.K., S.G., J.W., J.N.F., T.Y.W.), Christchurch Hospital, New Zealand.
Melissa LeungDepartment of Cardiology (M.L.), School of Clinical Medicine, South Western Sydney Clinical Campus, University of New South Wales, Australia.ORCID 0000-0002-1856-749X
Dennis CordatoDepartment of Neurology (D.S.G., D.C., M.W.P.), School of Clinical Medicine, South Western Sydney Clinical Campus, University of New South Wales, Australia.ORCID 0000-0001-8447-6644
Mark W ParsonsDepartment of Neurology (D.S.G., D.C., M.W.P.), School of Clinical Medicine, South Western Sydney Clinical Campus, University of New South Wales, Australia.ORCID 0000-0001-8874-2487
Neil J SprattDepartment of Neurology, John Hunter Hospital, College of Health, Medicine and Wellbeing, University of Newcastle, Australia (B.L.A.C., J.F., L.M.-R., N.J.S., C.G.-E.).ORCID 0000-0002-9023-6177
Carlos Garcia-Esperon *Department of Neurology, John Hunter Hospital, College of Health, Medicine and Wellbeing, University of Newcastle, Australia (B.L.A.C., J.F., L.M.-R., N.J.S., C.G.-E.).ORCID 0000-0001-8843-5890
Teddy Y Wu *Department of Neurology (A.B.-N., D.H.K., S.G., J.W., J.N.F., T.Y.W.), Christchurch Hospital, New Zealand.ORCID 0000-0003-1845-1769
Jonathan M Coutinho *Department of Neurology (S.S.N., L.A.R., C.F.P.B., M.G.M.H., D.S.A.R., J.M.C.), Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, the Netherlands.ORCID 0000-0002-8284-982X
AIS of HEARTS Collaborators

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCardiac computed tomography (CT) acquired during the acute stroke imaging protocol is an emerging modality to detect cardiac thrombi. We determined its yield in patients with acute ischemic stroke.

methodsWe performed a 1-stage individual patient data meta-analysis of 4 prospective observational cohorts (AIS of HEARTS [Acute Ischemic Stroke of Heart-Related Embolic Sources Detected on Acute Cardiac CT Scans]), including patients with acute ischemic stroke who underwent ECG-gated or non-ECG-gated cardiac CT between May 2018 and June 2024. We excluded patients with transient ischemic attack or stroke mimics. The primary outcome was the proportion of patients with a thrombus on cardiac CT. Secondary outcomes were additional scan time, radiation dose, comparison with echocardiography, and 90-day outcomes. We performed logistic regression analyses to compare 90-day outcomes between patients with and without thrombus, adjusting for age, sex, history of atrial fibrillation, ischemic heart disease, chronic heart failure, stroke or transient ischemic attack, anticoagulant use, prestroke modified Rankin Scale score, National Institutes of Health Stroke Scale score, large vessel occlusions, and intravenous thrombolysis, as appropriate for each outcome.

resultsWe included 3919 patients (median age, 74 [interquartile range (IQR), 63-82], 58% male, median National Institutes of Health Stroke Scale score 6 [IQR, 3-12]). Cardiac CT detected a thrombus in 243 (6.2%) patients. Among 1323 patients that underwent both cardiac CT and transthoracic echocardiography, cardiac CT had a higher yield than transthoracic echocardiography (odds ratio, 7.4 [95% CI, 4.0-15.1];

conclusionsImplementing cardiac CT into the acute stroke imaging protocol is feasible, detects thrombi in ≈6% of patients, and has a higher yield than transthoracic echocardiography. Cardiac thrombi were associated with higher mortality, but not higher stroke recurrence. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT07165093.

Indexed as

Heart DiseasesIschemic StrokeThrombosisTomography, X-Ray ComputedAgedAged, 80 and overBrain IschemiaEchocardiographyFemaleHumansMaleMiddle AgedProspective Studiesacute ischemic strokecardiac thrombuscardioembolicembolismhearttomography

Identifiers

PMID42227105
PMCPMC13399728

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.