CT angiography vs echocardiography for detection of cardiac thrombi in ischemic stroke: a systematic review and meta-ana
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ORIGINAL COMMUNICATION
CT angiography vs echocardiography for detection of cardiac thrombi in ischemic stroke: a systematic review and meta‑analysis Nina‑Suzanne Groeneveld1 · Valeria Guglielmi1 · Mariska M. G. Leeflang2 · S. Matthijs Boekholdt3 · R. Nils Planken4 · Yvo B. W. E. M. Roos1 · Charles B. L. M. Majoie4 · Jonathan M. Coutinho1 Received: 29 November 2019 / Revised: 16 February 2020 / Accepted: 18 February 2020 © The Author(s) 2020
Abstract Background and purpose Cardiac thrombi are an important cause of embolic stroke. We studied the diagnostic yield and diagnostic accuracy of cardiac CT angiography (CTA) compared to echocardiography for detection of cardiac thrombi in ischemic stroke patients. Methods We performed a systematic review and meta-analysis of the literature on cardiac CTA versus echocardiography for detection of cardiac thrombi in ischemic stroke patients. We included studies (N ≥ 20) in which both cardiac CTA (index test) and echocardiography (reference test) were performed and data on cardiac thrombi were reported. Results were stratified for type of echocardiography: transesophageal (TEE) vs transthoracic (TTE). Results Out of 1530 studies, 14 were included (all single center cohort studies), with data on 1568 patients. Mean age varied between 52 and 69 years per study and 66% were men. Reported time intervals ranged from 0 to 21 days between stroke and first test, and from 0 to 199 days between tests. In ten studies that compared CTA to TEE, CTA detected cardiac thrombi in 87/1385 (6.3%) patients versus 68/1385 (4.9%) on TEE (p
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