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

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.

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Key information

Conditions

Coronary Artery Embolism Acute Myocardial Infarction Type 2 Arrhythmias, Cardiac Atrial Fibrillation Cardiovascular Diseases Heart Diseases Pathologic Processes Pathological Conditions, Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Observational

Primary location

First Affiliated Hospital of Ningbo University, Ningbo, Zhejiang, China

About this study

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.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

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.

Treatment and study plan

Is it coronary artery embolism

Other

This observational study categorizes patients with acute myocardial infarction (AMI) into three distinct groups based on their clinical characteristics:

Group 1: Patients with atrial fibrillation (AF) and coronary artery embolism (CAE).
Group 2: Patients with AF but non-coronary artery embolism myocardial infarction (non-CAE MI).
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.

Primary outcomes

All-cause death, cardiogenic death

Time frame: Up to 10 years
Major Adverse Cardiovascular and Cerebrovascular Events

Time frame: Up to 10 years
Systemic thrombo-embolism

Time frame: Up to 10 years

Brain embolism, lower extremity arterial embolism, mesenteric arterial embolism, coronary artery embolism, splenic embolism, renal embolism.
Major hemorrhage

Time frame: Up to 10 years

BARC Grades 3-5 Bleeding

Sponsors and collaborators

Lead sponsor

First Affiliated Hospital of Ningbo University

Network

Registry information

Important dates

Study start: 2024
Primary completion: 2024
Study completion: 2024
First posted: Feb 25, 2025
Registry last updated: Feb 25, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.

Completed