| Title: |
Abstract DP126: ECG-gated versus non-ECG-gated cardiac CT protocols for cardiac thrombus detection in acute ischemic stroke. |
| Authors: |
MENA ROMO, LUIS; Nio, Shan Sui; Berry-Noronha, Alexander; Spratt, Neil; Green, Daniel; Hasnain, Md; Chew, Beng Lim Alvin; Fridgant, Joshua; Rinkel, Leon; Beemsterboer, Chiel; Planken, R. Nils; van Randen, Adrienne; Hilt, Mirre; Ruhe, Deborah; Bouma, Berto; Boekholdt, S; Kim, Dong Hyun; Guo, Shuyu; Alamri, Yassar; Winders, Joel; Senadeera, Sajith; Lim, Anthony; Fink, John; Leung, Melissa; Cordato, Dennis; Parsons, Mark; Wu, Teddy; Coutinho, Jonathan; Garcia-Esperon, Carlos |
| Source: |
Stroke ; volume 57, issue Suppl_1 ; ISSN 0039-2499 1524-4628 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2026 |
| Description: |
Background: The rate of intracardiac thrombus detection in the hyperacute phase of stroke varies from 5% to 12% between studies. Our aim was to compare the thrombus detection rate between ECG-gated and non-ECG-gated cardiac CT protocols in acute stroke patients, using data from a large, international, multicentre registry. Methods: We conducted an individual patient data meta-analysis by pooling prospective and retrospective observational data from stroke patients assessed at four comprehensive stroke centres who underwent either ECG-gated or non-ECG-gated cardiac CT (extended CT angiography or two-phase non-ECG-gated cardiac CT) as part of the acute stroke imaging protocol between May 2018 and June 2024. The primary outcome was the proportion of patients with a cardiac thrombus in gated vs non gated techniques. Results: Of 3,940 patients, 1,474 (37.4%) underwent ECG-gated and 2,466 (62.6%) non-ECG-gated cardiac CT. Patients in the ECG-gated group were younger (median age 72 [IQR 62–81] vs. 74 [IQR 64–82] years, p = 0.000) and had a lower NIHSS at baseline (median 5 [IQR 2–12] vs. 6 [IQR 3–13], p < 0.00). There was a higher rate of thrombus detection with ECG-gated CT compared to non-gated CT (7.5% vs. 5.5%, p = 0.011. The association remained significant after adjusting for age, sex, baseline NIHSS score, and baseline atrial fibrillation (adjusted OR 1.87, 95% CI 1.42–2.47, p = 0.000). ECG-gated CT was associated with lower radiation dose (3.6 vs. 6.3 mSv, p = 0.000) but longer acquisition time (5.8 vs. 0.28 min, p = 0.000). Conclusion: ECG-gated cardiac CT has a higher detection rate for intracardiac thrombus detection compared to non-ECG-gated CT in patients with acute ischemic stroke. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1161/str.57.suppl_1.dp126 |
| Availability: |
https://doi.org/10.1161/str.57.suppl_1.dp126 |
| Accession Number: |
edsbas.16AD1DB3 |
| Database: |
BASE |