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Cardio-cerebral infarction: a narrative review of pathophysiology, treatment challenges, and prognostic implications
Weiwei Gao1, Lingfeng Yu1, Jingjing She1
1Department of Neurology, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, National Advanced Center for Stroke, Xiamen, China.
Insights
Cardio-cerebral infarction (CCI), a rare condition combining heart attack and stroke, lacks clear guidelines. This review synthesizes current knowledge to improve diagnosis and treatment for better patient outcomes.
Area of Science:
- Cardiology
- Neurology
- Vascular Medicine
Background:
- Cardio-cerebral infarction (CCI) involves simultaneous or sequential acute myocardial infarction (AMI) and acute ischemic stroke (AIS).
- CCI presents a complex pathogenesis and poorer prognosis than isolated AMI or AIS.
- Existing research is limited, lacking consensus on definition, classification, epidemiology, and management.
Purpose of the Study:
- To systematically review CCI's definition, classification, epidemiology, pathogenesis, and therapeutic strategies.
- To analyze current treatment progress, limitations, and optimize individualized management.
- To guide future research and clinical practice for improved patient outcomes.
Main Methods:
- Narrative review of existing literature on cardio-cerebral infarction.
- Systematic examination of diagnostic criteria, epidemiological data, and etiological factors.
- Analysis of therapeutic strategies including reperfusion, antiplatelet, and anticoagulation therapies.
Main Results:
- No established consensus exists for CCI definition, classification, or management protocols.
- Current clinical practice often relies on single-disease guidelines, potentially compromising care.
- Evidence on safety and efficacy of various treatment strategies in CCI is limited.
Conclusions:
- Standardized diagnostic and treatment guidelines are crucial for effective CCI management.
- Individualized treatment approaches considering reperfusion, antiplatelet, and anticoagulation therapies are necessary.
- Further research is needed to establish evidence-based recommendations and improve long-term prognoses for CCI patients.
Abstract:
Cardio-cerebral infarction (CCI) is a rare clinical syndrome characterized by the simultaneous or sequential occurrence of acute myocardial infarction (AMI) and acute ischemic stroke (AIS). Despite its complex pathogenesis and more severe prognosis compared to isolated AMI or AIS, no consensus has been established regarding its definition, classification, epidemiology, treatment protocols, or prognostic management. Current research is largely confined to case reports or small case series, and there are no unified diagnostic or treatment guidelines, nor any expert consensus. Consequently, clinicians often rely on single-disease guidelines for AMI or AIS, or personal experience, when managing CCI cases. This approach complicates treatment decisions and may result in missed opportunities for optimal interventions, thereby adversely affecting long-term patient outcomes. This narrative review aimed to systematically summarize the definition, classification, epidemiological features, pathogenesis and therapeutic strategies, and prognostic aspects of CCI while thoroughly examining the progress and limitations of existing studies to guide future research and clinical practice. By offering a detailed analysis of reperfusion strategies, antiplatelet therapy, and anticoagulation in CCI patients, this review highlights the safety and efficacy differences among current treatments and explores methods for optimizing individualized management to improve clinical outcomes. Furthermore, this article aimed to enhance clinicians' understanding of CCI, provide evidence-based recommendations for patient care, and outline directions for future research. Ultimately, by refining diagnostic and therapeutic strategies, we aimed to reduce CCI-related mortality and improve long-term prognoses for affected patients.
