Acute Myocardial Infarction Type 2, Coronary Artery Embolism
Conditions
Keywords
coronary artery ebolism, acute myocardial infarction, atrial fibrillation
Brief summary
The goal of this observational study is to learn about the Prevalence, Clinical Features, and Prognosis of Coronary Artery Embolism With Concomitant Atrial Fibrillation. The main question it aims to answer is: What is the proportion of coronary artery embolism with concomitant atrial fibrillation among all myocardial infarctions and myocardial infarctions with concomitant atrial fibrillation? What are the clinical characteristics of coronary artery embolism with concomitant atrial fibrillation? What is the prognosis of coronary artery embolism with concomitant atrial fibrillation? All participants will receive routine diagnosis and treatment, and baseline demographic data, clinical examination laboratory results, and follow-up data will be collected for analysis.
Detailed description
The study is designed as an observational study without involving experimental drugs or device interventions, only collecting data from routine medical practice. Importance: Atrial fibrillation (AF) and acute myocardial infarction (AMI) share common risk factors and interact pathophysiologically. Coronary embolism (CE) is a critical mechanism of AMI in AF patients, yet its clinical features and prognosis remain understudied. Objective: To investigate the incidence, clinical characteristics, and prognosis of CE in patients with AF. Design, Setting, and Participants: A single-center retrospective case-control study was conducted at the Affiliated First Hospital of Ningbo University, China. Patients diagnosed with AMI who underwent coronary angiography (CAG) between January 1, 2014, and December 31, 2023, were included. CE was diagnosed using the Shibata criteria. Participants were categorized into three groups: AF-related CE, non-CE AF with AMI, and AMI without AF. Main Outcomes and Measures: Baseline characteristics, clinical features, coronary involvement, treatment strategies, and outcomes (all-cause mortality, cardiac-death mortality, major adverse cardiovascular and cerebrovascular events \[MACCE\], recurrent embolism, and major bleeding) were compared.
Interventions
OTHERIs it coronary artery embolism
This observational study categorizes patients with acute myocardial infarction (AMI) into three distinct groups based on their clinical characteristics: 1. Group 1: Patients with atrial fibrillation (AF) and coronary artery embolism (CAE). 2. Group 2: Patients with AF but non-coronary artery embolism myocardial infarction (non-CAE MI). 3. Group 3: Patients without AF and non-coronary artery embolism myocardial infarction (non-CAE MI without AF). A key innovation of this study compared to previous research is its expanded eligibility criteria for AMI patients. Earlier studies typically focused exclusively on ST-segment elevation myocardial infarction (STEMI). In contrast, this investigation encompasses a broader spectrum of acute myocardial infarction, including both STEMI and non-ST-segment elevation myocardial infarction (NSTEMI). This comprehensive approach enhances the generalizability and applicability of the findings by capturing a wider range of clinical scenarios.
Sponsors
First Affiliated Hospital of Ningbo University
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of Acute myocardial infarction * Selective coronary angiography has been performed.
Exclusion criteria
* Clinical diagnosis of Iatrogenic coronary artery embolism * Clinical diagnosis of Coronary artery dilation * Clinical diagnosis of Coronary in-stent thrombosis and embolism * Clinical diagnosis of Coronary slow flow syndrome * Clinical diagnosis of Coronary artery dissection * Clinical diagnosis of Coronary artery spasm * Pathological examination showed that the embolus contained atherosclerotic plaque * Endovascular imaging examinations, including intravascular ultrasound (IVUS) and optical coherence tomography (OCT), indicate the presence of plaque rupture, erosion, or ulceration in the culprit vessel. * Clinical diagnosis of Previous myocardial infarction * Previous coronary stent implantation or coronary artery bypass surgery.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| All-cause death, cardiogenic death | Up to 10 years | — |
| Major Adverse Cardiovascular and Cerebrovascular Events | Up to 10 years | — |
| Systemic thrombo-embolism | Up to 10 years | Brain embolism, lower extremity arterial embolism, mesenteric arterial embolism, coronary artery embolism, splenic embolism, renal embolism. |
| Major hemorrhage | Up to 10 years | BARC Grades 3-5 Bleeding |
Countries
China
Outcome results
None listed