Prevalence, Clinical Features, and Prognosis of Coronary Artery Embolism with Concomitant Atrial Fibrillation

First Affiliated Hospital of Ningbo University

Status

Completed

Conditions

Coronary Artery Embolism

Acute Myocardial Infarction Type 2

Treatments

Other: Is it coronary artery embolism

Study type

Observational

Funder types

NETWORK

Identifiers

NCT06845956

Grant No 2022L001 (Other Grant/Funding Number)

2021C03096 (Other Grant/Funding Number)

Project No. 213RS, 2024

Details and patient eligibility

About

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.

Full 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.

Enrollment

5,163 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

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.