{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T13:53:43Z","timestamp":1781790823324,"version":"3.54.5"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,6,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The final infarct volume has been historically considered the most critical radiological outcome in ischemic stroke. Yet, discrepancies between final infarct volume and functional outcomes occur frequently. We aim to evaluate whether 24\u2010hour computed tomography (CT) infarct density modifies the relationship between 24\u2010hour CT infarct volume and functional outcomes and is associated with outcomes in acute ischemic stroke.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Data are from the AcT (Alteplase Versus Tenecteplase in AIS [Acute Ischemic Stroke] Within 4.5\u2009Hours) trial. Patients with detected 24\u2010hour CT infarct and no parenchymal hematoma were included. To capture within\u2010lesion heterogeneity, \u201c24\u2010hour CT standardized infarct density\u201d was calculated as mean Hounsfield Unit\/SD for every patient. Primary outcome was the 90\u2010day ordinal modified Rankin Scale score. We assessed effect modification using interaction terms and performed adjusted regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Of 1577 patients, 839 (53.2%) were included (median age 75\u2009years [interquartile range, 64\u201384], 414 [9.3%] female). Median infarct volume was 7.5\u2009mL (interquartile range, 1.6\u201328.0), and median standardized infarct density was 4.8 standardized\u2010Hounsfield Units (interquartile range, 4.0\u20135.8). Standardized infarct density significantly modified the effect of infarct volume on modified Rankin Scale score (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      \u2010interaction=0.001) and mortality (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      \u2010interaction=0.014). Higher standardized infarct density (ie, less severe infarct degree) was associated with better 90\u2010day modified Rankin Scale score (adjusted common odds ratio [acOR], 0.87 [95% CI, 0.80\u20130.96] per 1\u2010standardized\u2010Hounsfield Unit increase), whereas infarct volume was not (acOR, 0.96 [95% CI, 0.90\u20131.01] per 5\u2010mL increase).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">CT infarct density modifies the effect of infarct volume on outcomes and is independently associated with better outcomes. These findings suggest that 24\u2010hour CT infarct volume and density may provide complementary information on the infarct burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046038","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T10:49:37Z","timestamp":1779706177000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Association of 24\u2010Hour Computed Tomography Infarct Density on Functional Outcomes in Stroke: Secondary Analysis From the AcT Trial"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4042-4735","authenticated-orcid":false,"given":"Umberto","family":"Pensato","sequence":"first","affiliation":[{"name":"IRCCS Humanitas Research Hospital","place":["Milan, Italy"]},{"name":"Humanitas University","place":["Milan, Italy"]},{"name":"University of Calgary","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0330-6908","authenticated-orcid":false,"given":"Jianhai","family":"Zhang","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8152-1382","authenticated-orcid":false,"given":"Kazbek","family":"Barakhanov","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6501-4057","authenticated-orcid":false,"given":"Koji","family":"Tanaka","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6748-2081","authenticated-orcid":false,"given":"Fouzi","family":"Bala","sequence":"additional","affiliation":[{"name":"University Hospital of Tours","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8316-6820","authenticated-orcid":false,"given":"Chitapa","family":"Kaveeta","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Canada"]},{"name":"Mahidol University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9550-8197","authenticated-orcid":false,"given":"Mohammed","family":"Almekhlafi","sequence":"additional","affiliation":[{"name":"University of Calgary","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1379-3612","authenticated-orcid":false,"given":"Dar","family":"Dowlatshahi","sequence":"additional","affiliation":[{"name":"University of Ottawa","place":["Ottawa, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1176-0633","authenticated-orcid":false,"given":"Thalia S.","family":"Field","sequence":"additional","affiliation":[{"name":"University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4063-4431","authenticated-orcid":false,"given":"Aleksander","family":"Tkach","sequence":"additional","affiliation":[{"name":"Interior Health","place":["Kelowna, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6571-5531","authenticated-orcid":false,"given":"Rick","family":"Swartz","sequence":"additional","affiliation":[{"name":"University of Toronto","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2033-8001","authenticated-orcid":false,"given":"Gary","family":"Hunter","sequence":"additional","affiliation":[{"name":"University of Saskatchewan","place":["Saskatoon, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3707-9723","authenticated-orcid":false,"given":"Jai J. 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