Mortality rates after acute ischemic stroke remain high despite continuously improving treatment. In this context, it is important to note that a relevant portion of acute ischemic stroke patients die from adverse cardiovascular events, such as myocardial infarction, rather than from complications associated with the stroke itself. A possible reason might be that this patient group often suffers from at least moderate asymptomatic coronary artery disease. This study seeks to integrate cardiac computed tomography angiography into the standard-of-care diagnostic protocol of acute ischemic stroke. The aim of this prospective mono-centric trial is to enable accurate diagnosis of therapy-relevant coronary artery disease, other concomitant cardiac findings and cardiac causes of acute ischemic stroke, without delaying stroke therapy. In the long-run, the goal is to investigate whether cardiac computed tomography angiography and the resulting therapeutic measures (interventions or medications added) can improve functional outcome and rate of adverse cardiac complications in patients with acute ischemic stroke compared to a retrospective matched-cohort of patients without cardiac CT imaging.

Inclusion Criteria:

• Patients aged 40 years or above, presenting at the Emergency Department of the University Medical Center Hamburg-Eppendorf with a suspected acute ischemic stroke and a relevant neurological deficit (NIHSS score > 4).

Exclusion Criteria:

• A causal differential diagnosis for the acute stroke syndrome with absent intracranial vessel occlusion.
• No correlation for the patients' symptoms in the cranial CTA (no vessel obstruction).

Patients aged 40 years or above, presenting at the Emergency Department of the University Medical Center Hamburg-Eppendorf (primary care clinic) with a suspected AIS.

Due to data protection agreements, it is not possible to share the IPD. Nevertheless,parts of the datasets can be made available from the PIs upon reasonable request.