Detection of Myocardial Infarction by Non-ECG Gated, Contrast-Enhanced CT: Initial Experience

Coronary heart disease is a leading cause of death in developed countries. While ECG-gated coronary CT is commonly used to detect coronary artery stenosis, the role of non-ECG-gated CT (NECE-CT) in detecting myocardial infarction (MI) remains underexplored, particularly in emergency settings where rapid diagnosis is crucial. This study retrospectively analyzed 22 suspected MI patients from the emergency department who underwent NECE-CT without an initial diagnosis of AMI or available cardiac enzyme or ECG data. Acute MI was confirmed in 45% (n = 10) of patients, with 30% (n = 3/10) showing elevated troponin-I levels only after the CT exam. In the MI group, all patients had perfusion defects, with 20% (n = 2) showing transmural defects and 80% (n = 8) showing endocardial defects. In contrast, all patients in the non-MI group exhibited endocardial defects. Coronary artery calcification was significantly higher in the MI group (70%) compared to the non-MI group (25%, p < 0.05). These findings suggest that NECE-CT can reliably detect MI, with some cases being diagnosed earlier than with standard methods. Further prospective studies are needed to confirm its efficacy in early MI detection.