Cardiac CT Angiography in Patients With Acute Ischemic Stroke

Study Overview
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Brief Summary
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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.

Official Title
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Assessment of Cardiac CT Angiography in Patients Undergoing Thrombectomy for Ischemic Stroke

Conditions
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Acute Ischemic Stroke, Coronary Artery Disease

Intervention / Treatment
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* Diagnostic Test: Cardiac Computed Tomography Angiography


Participation Criteria
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Eligibility Criteria
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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).

Ages Eligible for Study
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Minimum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Cardiac Computed Tomography Angiography<br>Patients with acute ischemic stroke who receive cardiac computed tomography angiography as part of the routine diagnostic work-up of acute ischemic stroke. | Diagnostic Test: Cardiac Computed Tomography Angiography<br>* Non-invasive imaging of the heart, the greater vessels and the coronary arteries using computed tomography.<br>|
| Retrospective matched cohort<br>A retrospective matched cohort of patients with acute ischemic stroke who did not receive cardiac computed tomography angiography. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diagnosis of therapy-relevant CAD and concomitant cardiac findings resulting in new therapeutic measurements. | Number of (newly) prescribed medications (e.g., anticoagulants), cardiac diagnostics/interventions/planned interventions, clinical status (NIHSS, mRs). | 1 day at hospital discharge | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The rate of adverse cardiovascular events (MACE). | rate of major adverse cardiovascular events (MACE). | 90 and 365 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Computed Tomography Angiography