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Atrial Fibrillation Related Coronary Embolism: Diagnosis in the Focus

László Balogh1, Péter Óvári1, Christopher Uwaafo Ugbodaga1

  • 1Department of Cardiology and Cardiac Surgery, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.

Journal of Personalized Medicine
|May 27, 2023
PubMed

Insights

Atrial fibrillation (AF) is linked to coronary embolism (CE) in ST-elevation myocardial infarction (STEMI) patients. The Shibata criteria aid in diagnosing AF-related CE, with thrombus aspiration proving useful.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Vascular Medicine

Background:

  • Atrial fibrillation (AF) is a common arrhythmia associated with myocardial infarction (MI).
  • Coronary embolism (CE) accounts for 4-5% of MI cases, with AF being a significant contributor.
  • The relationship between AF and MI, particularly AF-related CE, requires further investigation.

Purpose of the Study:

  • To determine the prevalence of AF-related CE in ST-elevation myocardial infarction (STEMI) patients.
  • To evaluate the diagnostic accuracy of the Shibata criteria for identifying AF-related CE.
  • To assess the role of thrombus aspiration in diagnosing AF-related CE.

Main Methods:

  • Retrospective analysis of 1181 STEMI patients over three years.
  • Application of the Shibata criteria for classifying CE cases.
  • PubMed search to identify and analyze previously reported AF-related CE cases.

Main Results:

  • 13.2% of STEMI patients had AF (157 out of 1181).
  • Shibata criteria identified 10 'definitive' and 31 'probable' CE cases, with 5 additional 'definitive' cases upon re-evaluation.
  • CE was more frequent in patients with known AF (16.7%) versus new-onset AF (5.1%).
  • Literature review found 40 applicable AF-related CE cases; 31 'definitive', 4 'probable'.
  • Thrombus aspiration aided diagnosis in 47% of the study's cases and 40% of reported cases.

Conclusions:

  • AF is a relevant factor in STEMI, with a notable prevalence of AF-related CE.
  • The Shibata criteria are valuable for diagnosing AF-related CE.
  • Thrombus aspiration can be a beneficial diagnostic tool in suspected AF-related CE.

Keywords:
atrial fibrillationcoronary embolismpersonalized thrombus aspiration

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