Outcomes of Cardio-Cerebral Infarction Patients: A Single-Centre Retrospective Study

Area of Science:

• Cerebrovascular Medicine
• Cardiology
• Acute Stroke Management

Background:

• Cardio-cerebral infarction (CCI) involves concurrent acute ischemic stroke (AIS) and acute myocardial infarction (AMI).
• This dual organ insult presents a significant clinical challenge with potentially devastating consequences.
• Growing interest exists in understanding and managing CCI within cerebrovascular medicine.

Purpose of the Study:

• To determine the incidence, treatment, and outcomes of CCI patients.
• To propose a potential treatment algorithm for managing CCI.
• To analyze clinical characteristics, progression, and management strategies for CCI.

Main Methods:

• Retrospective analysis of 1,921 acute ischemic stroke (AIS) patients admitted to a North London Hyper-Acute Stroke Unit (HASU) from January 2020 to December 2021.
• Patients were identified based on elevated troponins and confirmed diagnosis/treatment of myocardial infarction (MI) within 72 hours of AIS, or vice versa.
• Clinical data on admission, progression, management, and outcomes were collected and analyzed.

Main Results:

• Out of 1,921 AIS patients, 18 (0.9%) were diagnosed with CCI.
• In-hospital mortality for CCI patients was high at 41% (7 out of 18).
• Median length of stay was six days; 29% of MI cases were treated with angioplasty.

Conclusions:

• Cardio-cerebral infarction (CCI) is a rare condition with an exceptionally high mortality rate.
• Prompt recognition and appropriate, collaborative therapeutic interventions are vital for re-perfusion of both heart and brain.
• Establishing a clear CCI pathway involving stroke physicians, neuro-interventionalists, and cardiologists is essential for improved patient management and outcomes.