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- W4313443996 abstract "Coronary artery embolism (CE) is recognized as a nonatherosclerotic cause of acute myocardial infarction (MI) and represents about 0.5% of MI cases. Atrial fibrillation (AF) is the most frequent cause of CE, and in 26% of cases it is associated with multiple embolisms, particularly in the brain. In this prospective study, in patients with CE-associated MI: (a) cardiac magnetic resonance imaging was used to assessed the extent of infarct transmurality and myocardial necrosis size; and (b) brain magnetic resonance imaging was used to assess the proportion of simultaneous cardiocerebral infarction. We screened 1401 consecutive patients who presented with de novo acute MI from January 2019 to June 2021. CE was diagnosed based on clinical, angiographic, and diagnostic imaging criteria. Over the study period, 29 patients presented with CE (2.07%) and 21 patients underwent cardiac and cerebral MRI. Of these 21 patients, 9 had an ischemic stroke, and atrial fibrillation was the leading cause of coronary embolism in 14 patients (67%). In addition, coronary embolism was identified in 17/21 patients who underwent coronary angiography and multiple CE was observed in 7/21 patients (33%). Four patients (19%) had left atrial appendage thrombus (LAAt). None of the patients without a stroke (0/12) presented LAAt whereas 4 of the patients with a stroke (4/9, 44%) did. On cardiac MRI, the number of segments presenting images of acute infarction was on average 3 (min–max: 0–11), with 3 (min–max: 1–6) in patients without and 3 (min–max: 0–11) in patients with stroke. Most acute ischemic stroke was localized in the superficial sylvian territory and only 2/21 patients had stroke sequelae. Our analysis of cardiac MRI data shows that MI related to CE was associated with infarctions of average size but also with multiple locations. In addition, systematic brain MRI revealed that one third of the cases were associated with a stroke, which was not symptomatic in the majority of cases. Further studies are required to better characterize the pathophysiology, clinical course and prognostic value of CE. Moreover, optimal management strategies, including antiplatelet therapy, remain to be determined." @default.
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- W4313443996 date "2023-01-01" @default.
- W4313443996 modified "2023-09-26" @default.
- W4313443996 title "Acute myocardial infarction related to coronary artery embolism: A systematic cardiac and cerebral magnetic resonance imaging study" @default.
- W4313443996 doi "https://doi.org/10.1016/j.acvdsp.2022.10.129" @default.
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