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A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia
06:01

A Thrombotic Stroke Model Based On Transient Cerebral Hypoxia-ischemia

Published on: August 18, 2015

Risk factors for intracardiac thrombus in patients with recent ischaemic cerebrovascular events

S Sen1, S Laowatana, J Lima

  • 1Cerebrovascular Program, Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Journal of Neurology, Neurosurgery, and Psychiatry
|September 21, 2004
PubMed

Insights

Identifying cardiac thrombus risk factors helps select patients for transesophageal echocardiography (TOE). Clinical factors like large stroke and coronary artery disease predict thrombus presence, guiding preventative measures.

Area of Science:

  • Cardiology
  • Neurology
  • Medical Imaging

Background:

  • Intracardiac thrombus is a significant cause of cardiogenic cerebral ischemia.
  • Prompt detection and intervention are crucial for reducing high stroke recurrence rates.
  • Transesophageal echocardiography (TOE) is the gold standard for thrombus detection but is invasive and costly.

Purpose of the Study:

  • To identify clinical risk factors for intracardiac thrombus.
  • To enable targeted patient selection for TOE.
  • To guide preventative strategies against cardiac thrombus formation.

Main Methods:

  • 151 patients with ischemic stroke or transient ischemic attacks underwent TOE.
  • Patients were evaluated within one week of their neurological event.
  • Multivariate analysis was used to identify correlates of intracardiac thrombus.

Main Results:

  • Intracardiac thrombus was detected in 26% of patients, predominantly in the left atrial appendage (70%).
  • Risk factors included large stroke (OR=2.8), symptomatic coronary artery disease (OR=3.0), and ECG evidence of ischemia (OR=2.8).
  • Carotid stenosis >70% and stroke location did not correlate with thrombus presence.

Conclusions:

  • Clinical factors are significant predictors of cardiac thrombus in patients with recent cerebral ischemia.
  • These identified risk factors can guide the selection of patients for invasive TOE.
  • The findings support using clinical assessment for TOE selection, independent of carotid stenosis or stroke location.
Abstract

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