Citations 1
Abstract DP126: ECG-gated versus non-ECG-gated cardiac CT protocols for cardiac thrombus detection in acute ischemic stroke.
ROMO, LUIS MENA, Nio, Shan Sui , Berry, Alexander , Spratt, N., Green, Daniel, Hasnain, Md, Chew, Beng Lim Alvin , Fridgant, Joshua, Rinkel, Leon A, Beemsterboer, Chiel, Planken, R. Nils, Randen, Adriënne van , Hilt, Mirre, Ruhe, Deborah, Bouma, B., Boekholdt, S, Kim, Dong Hyun, Guo, Shuyu, Winders, Joel, Senadeera, Sajith C. , Lim, Anthony , Fink, John , Leung, Melissa, Parsons, Mark, Wu, Teddy, Coutinho, Jonathan, Garcia-Esperon, Carlos, Romo, Luis Mena, Spratt, Neil J , Hasnain, Md Golam , Rinkel, Leon A. , Beemsterboer, Chiel F.P. , Planken, R. Nils , Hilt, Mirre , Boekholdt, S. Matthijs , Alamri, Yassar , Lim, Anthony T , Cordato, Dennis , Parsons, Mark W , Wu, Teddy Y , Garcia-Esperon, Carlos
Stroke | January 29, 2026 | Volume: 57 | Issue: Suppl_1 | Pages: No page available
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.