دورية أكاديمية
أعرض في EDS

Long-Term Clinical Implications of High-Risk Cardiac Computed Tomography Findings in Patients With Acute Ischemic Stroke.

التفاصيل البيبلوغرافية
العنوان: Long-Term Clinical Implications of High-Risk Cardiac Computed Tomography Findings in Patients With Acute Ischemic Stroke.
المؤلفون: Rinkel LA; Department of Neurology, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Cramer ON MD; Department of Neurology, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Özata ZB; Department of Neurology, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Beemsterboer CFP; Department of Neurology, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Guglielmi V; Department of Neurology, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Nio SS; Department of Neurology, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Bouma BJ; Department of Cardiology, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Boekholdt SM; Department of Cardiology, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Lobé NHJ; Departments of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Beenen LFM; Departments of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Marquering HA; Departments of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands.; Departments of Biomedical Engineering and Physics, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Majoie CBLM; Departments of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Roos YBWEM; Department of Neurology, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., van Randen A; Departments of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Planken RN; Departments of Radiology and Nuclear Medicine, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands., Coutinho JM; Department of Neurology, Amsterdam UMC Location University of Amsterdam Amsterdam The Netherlands.
المصدر: Journal of the American Heart Association [J Am Heart Assoc] 2024 May 07; Vol. 13 (9), pp. e033175. Date of Electronic Publication: 2024 Apr 19.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Oxford : Wiley-Blackwell
مواضيع طبية MeSH: Ischemic Stroke*/diagnostic imaging , Ischemic Stroke*/mortality, Humans ; Male ; Female ; Aged ; Prospective Studies ; Middle Aged ; Risk Factors ; Time Factors ; Risk Assessment ; Recurrence ; Tomography, X-Ray Computed ; Prognosis ; Aged, 80 and over ; Predictive Value of Tests
مستخلص: Background: Cardiac computed tomography (CT) acquired during the initial acute stroke imaging protocol (acute cardiac CT) is increasingly used to screen for cardioembolism, but information on the long-term clinical implications of its findings is lacking.
Methods and Results: We performed a prospective, single-center cohort study in which consecutive patients with ischemic stroke underwent ECG-gated acute cardiac CT and were followed up for 2 years. The primary outcome was functional outcome assessed using the modified Rankin Scale. Secondary outcomes were death and occurrence of major adverse cardiovascular events (composite of recurrent ischemic stroke, myocardial infarction, and cardiovascular death). We compared patients with and without a high-risk structural source of embolism on acute cardiac CT. Of 452 included patients, 55 (12.2%) had a high-risk source of embolism, predominantly cardiac thrombi (38 patients) and signs of endocarditis (8 patients). Follow-up at 2 years was complete for 430 (95.1%) patients. Patients with a high-risk source of embolism had a worse functional outcome (median modified Rankin Scale, 6 [IQR, 2-6] versus 2 [IQR, 1-5]; adjusted common odds ratio, 2.92 [95% CI, 1.62-5.25]), increased mortality rate (52.7% versus 23.7%; adjusted hazard ratio [HR], 3.28 [95% CI, 1.94-5.52]), and major adverse cardiovascular events (38.9% versus 17.5%; adjusted HR, 3.20 [95% CI, 1.80-5.69]). A high-risk source of embolism was not associated with recurrent ischemic stroke (11.1% versus 9.6%; adjusted HR, 1.30 [95% CI, 0.49-3.44]).
Conclusions: Structural high-risk sources of embolism on acute cardiac CT in patients with ischemic stroke were associated with poor long-term functional outcome and occurrence of major adverse cardiovascular events but not with recurrent stroke.
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فهرسة مساهمة: Keywords: cardiac CT; ischemic stroke; outcomes
تواريخ الأحداث: Date Created: 20240419 Date Completed: 20240507 Latest Revision: 20240618
رمز التحديث: 20240618
مُعرف محوري في PubMed: PMC11179910
DOI: 10.1161/JAHA.123.033175
PMID: 38639349
قاعدة البيانات: MEDLINE
الوصف
تدمد:2047-9980
DOI:10.1161/JAHA.123.033175