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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.
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:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Amsterdam UMC | Patients from Amsterdam UMC that underwent ECG-gated cardiac CT | ||
| Christchurch Hospital | Patients from Christchurch hospital that underwent non-ECG gated cardiac CT | ||
| John Hunter Hospital | Patients from John Hunter Hospital that underwent non-ECG gated cardiac CT | ||
| Liverpool Hospital | Patients from Liverpool Hospital that underwent ECG-gated cardiac CT |
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| Measure | Description | Time Frame |
|---|---|---|
| Proportion of patients with cardiac thrombus detected on acute cardiac CT. | The proportion of patients with acute ischemic stroke that have a cardiac thrombus detected on cardiac CT. | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Comparison between cardiac CT and echocardiography for the detection of cardiac thrombi. | Proportion of acute ischemic stroke patients with a cardiac thrombus on cardiac CT and echocardiography, in patients that underwent both investigations. | An average of within 1 year: the investigators 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. |
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Inclusion Criteria:
Exclusion Criteria:
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Patients 18 years or older with acute ischemic stroke that underwent a cardiac CT during the acute stroke scanprotocol.
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| Name | Affiliation | Role |
|---|---|---|
| Jonathan Coutinho, MD, PhD | Amsterdam UMC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Amsterdam UMC | Amsterdam | 1105 AZ | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 42227105 | Derived | Nio SS, Green DS, Berry-Noronha A, Rinkel LA, Beemsterboer CFP, Hasnain MG, Planken RN, van Randen A, Al-Hadethi S, Hilt MGM, Ruhe DSA, Bouma BJ, Boekholdt SM, Chew BLA, Fridgant J, Mena-Romo L, Kim DH, Guo S, Alamri Y, Winders J, Senadeera SC, Lim AT, Fink JN, Leung M, Cordato D, Parsons MW, Spratt NJ, Garcia-Esperon C, Wu TY, Coutinho JM; AIS of HEARTS Collaborators. Diagnostic Yield of Cardiac CT to Detect Cardiac Thrombi in Patients With Acute Ischemic Stroke (AIS of HEARTS). Stroke. 2026 Jun 2. doi: 10.1161/STROKEAHA.126.055575. Online ahead of print. |
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| Follow up 90 days: mortality compared between patients with and without thrombus | Proportion of patients that died at 90 days follow-up after stroke onset. | From stroke onset until 90 days follow-up |
| Follow-up 90 days: recurrent stroke | Proportion of patients that had a recurrent stroke at 90 days follow-up after stroke onset. A recurrent stroke needs to be clearly defined, based on clinical, imaging and other diagnostic information | Stroke onset until 90 days follow-up |
| Follow-up 90 days: outcome using modified rankin scale score | Functional outcome at 90 days, measured using the modified rankin scale (mRS) score. The mRS score is a scale from 0-6. Higher scores mean a worse functional outcome. | Stroke onset until 90 days follow-up |
| ID | Term |
|---|---|
| D000083242 | Ischemic Stroke |
| D000083262 | Embolic Stroke |
| D013927 | Thrombosis |
| ID | Term |
|---|---|
| D020521 | Stroke |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D016769 | Embolism and Thrombosis |
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