ABSTRACT NUMBER: ESOC2026A471 DETECTION OF CARDIAC THROMBI BY CT IN PATIENTS WITH TRANSIENT ISCHAEMIC ATTACK

Abstract Background and aims Cardiac CT integrated into acute stroke imaging protocol detects cardiac thrombi in approximately 6-8% of patients with acute ischemic stroke (AIS). We assessed the yield of cardiac CT in patients with transient ischaemic attacks (TIA). Methods We compared the data from the AIS of HEARTS collaboration with contemporaneous TIA patients presenting to four hospitals in the Netherlands, Australia, and New Zealand. We compared the rate of cardiac thrombi detected between TIA and AIS patients using standard descriptive statistics and determined the association using multivariable logistic regression analysis. Results We included data of 313 TIA and 3919 AIS patients. Compared with AIS patients, TIA patients had similar age (median 73 vs 74, p=0.227), similar sex distribution (female 40.9% vs 42%, p=0.72), lower baseline NIHSS (median 1 vs 6 p<0.001), and significantly less atrial fibrillation (AF) (14.7% vs 23.3%, p<0.001). A cardiac thrombus was detected in only 1.3% (n=4) of TIA patients, compared with 6.2% (n=243) in AIS (p<0.001). This association remained statistically significant after adjusting for age, sex, AF, heart failure, ischaemic heart disease (OR 0.24, 95% CI 0.09-0.64, p=0.005). Among TIA patients, those with cardiac thrombi more frequently had AF at baseline (50% vs 14.2%) and MACE at 90-day follow up (25% vs 2.6%). There was no difference in recurrent stroke (0% vs 6.6%) and functional outcome (mRS 0-2: 75% vs 89%). Conclusions The yield of cardiac CT in the acute stroke imaging protocol to detect cardiac thrombi is low in TIA patients compared AIS patients. Conflict of interest Shuyu Guo: nothing to disclose. Mirre Hilt: nothing to disclose. Shan Sui Nio: nothing to disclose. Md Golam Hasnain: nothing to disclose. Daniel S. Green: Nil conflicts of interest. This research was supported by the Australian Government Research Training Program Scholarship. John Fink: nothing to disclose. Mark Parsons: nothing to disclose. Carlos Garcia-Esperon: nothing to disclose. Teddy Wu: nothing to disclose. Jonathan Coutinho: nothing to disclose.