A total of 1,272,456 patients with acute ischemic stroke were identified during our study period, of whom 7545 (0.6%) had cardiac thrombus. The median age (IQR) was 64 years (54,74) for the cardiac thrombus group and 69 years (58,79) for patients without cardiac thrombus. Baseline comorbidities such as congestive heart failure (CHF) (57% vs. 16%, p < 0.001), coronary artery disease (54% vs. 27%, p < 0.001), non-ischemic cardiomyopathy (20% vs. 3.2%, p < 0.001), and atrial fibrillation/flutter (35 vs. 22%, p < 0.001) more prevalent in the cardiac thrombus group Table 1.

After propensity-score matching, both groups were well-balanced in terms of baseline characteristics (Table 2).

There was an uptrend of cardiac thrombus prevalence from 0.4% in 2016 (1,093 cases) to 0.7% (2,566 cases) during the study period (P value < 0.001) (Fig. 1).

Trends in the prevalence of concurrent cardiac thrombus and acute ischemic

The median length of hospital stay (LOS) for patients with cardiac thrombus was 5 days, whereas it was 3 days for patients without cardiac thrombus (p < 0.001 as shown in the table. There was no significant difference in inpatient mortality for index hospitalization between patients with or without cardiac thrombus.

In the matched cohort, there was a higher frequency of advanced interventions, such as EVT (5.6% vs. 3.9%, p = 0.004), in the group with cardiac thrombus, while there was no difference in the utilization of tissue plasminogen activator (TPA) or both TPA and EVT between the two groups. The rate of 30-day readmission did not differ between patients with and without cardiac thrombus. However, patients with cardiac thrombus exhibited a higher risk of gastrointestinal bleeding and hemorrhagic stroke, likely attributable to the use of anticoagulation in this group (Table 3).