Coronary embolism resulting in myocardial infarction: diagnosis and treatment

Abstract Background Coronary embolism (CE) is rare and is an unusual cause of acute myocardial infarction (AMI). Japan NCVC criteria of CE were the first criteria that did not be verified and accepted. Methods We collected all the CE patients in our hospital between 2015 and 2021, analyzed the chara...

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Main Authors: Shufu Chang, Rende Xu, Yuxiang Dai, Chenguang Li, Hao Lu, Qing Qin, Jianying Ma, Juying Qian, Junbo Ge
Format: Article
Language:English
Published: BMC 2025-07-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02914-8
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author Shufu Chang
Rende Xu
Yuxiang Dai
Chenguang Li
Hao Lu
Qing Qin
Jianying Ma
Juying Qian
Junbo Ge
author_facet Shufu Chang
Rende Xu
Yuxiang Dai
Chenguang Li
Hao Lu
Qing Qin
Jianying Ma
Juying Qian
Junbo Ge
author_sort Shufu Chang
collection DOAJ
description Abstract Background Coronary embolism (CE) is rare and is an unusual cause of acute myocardial infarction (AMI). Japan NCVC criteria of CE were the first criteria that did not be verified and accepted. Methods We collected all the CE patients in our hospital between 2015 and 2021, analyzed the characters, diagnosis, and treatment, and confirmed the value of Japan NCVC criteria. Results Eighteen AMI patients diagnosed with CE were enrolled. Seventeen patients (94.4%) were given PCI treatments. Six patients (33.3%) had artificial heart valves, and three (16.7%) had mechanical valves. Eleven patients (61.1%) had atrial fibrillation (AF), one (5.6%) had hypertrophic cardiomyopathy, and two (11.1%) had hypercoagulable state. 68.8% of patients had insufficient anticoagulation in this study. Seven patients (38.9%) fulfilled the criteria for definite CE, and nine (50%) were classified as probable CE. The other two patients (11.1%) did not fulfill the criteria of CE with distal coronary artery embolism and one criterion of Japan NCVC criteria. The diagnosis accuracy rate of Japan NCVC criteria was 88.9%. Thrombus aspiration was the first-line treatment used in 14 patients (77.8%) and performed in 9 vessels (47.4%) as the only treatment method. Conclusions CE is rare in AMI, and AF is the most critical cause which should draw our attention. The Japan NCVC criteria were a helpful diagnostic tool for CE with high accuracy, but the distal coronary artery embolism with moderate atherosclerosis might be overlooked. Thrombus aspiration was the preferred treatment to remove thrombus and restore coronary flow to improve prognosis.
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spelling doaj-art-4bf9e6f7e69648e49c5d0103dcaa78172025-08-20T03:42:27ZengBMCEuropean Journal of Medical Research2047-783X2025-07-013011810.1186/s40001-025-02914-8Coronary embolism resulting in myocardial infarction: diagnosis and treatmentShufu Chang0Rende Xu1Yuxiang Dai2Chenguang Li3Hao Lu4Qing Qin5Jianying Ma6Juying Qian7Junbo Ge8Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan UniversityDepartment of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan UniversityDepartment of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan UniversityDepartment of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan UniversityDepartment of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan UniversityDepartment of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan UniversityDepartment of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan UniversityDepartment of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan UniversityDepartment of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan UniversityAbstract Background Coronary embolism (CE) is rare and is an unusual cause of acute myocardial infarction (AMI). Japan NCVC criteria of CE were the first criteria that did not be verified and accepted. Methods We collected all the CE patients in our hospital between 2015 and 2021, analyzed the characters, diagnosis, and treatment, and confirmed the value of Japan NCVC criteria. Results Eighteen AMI patients diagnosed with CE were enrolled. Seventeen patients (94.4%) were given PCI treatments. Six patients (33.3%) had artificial heart valves, and three (16.7%) had mechanical valves. Eleven patients (61.1%) had atrial fibrillation (AF), one (5.6%) had hypertrophic cardiomyopathy, and two (11.1%) had hypercoagulable state. 68.8% of patients had insufficient anticoagulation in this study. Seven patients (38.9%) fulfilled the criteria for definite CE, and nine (50%) were classified as probable CE. The other two patients (11.1%) did not fulfill the criteria of CE with distal coronary artery embolism and one criterion of Japan NCVC criteria. The diagnosis accuracy rate of Japan NCVC criteria was 88.9%. Thrombus aspiration was the first-line treatment used in 14 patients (77.8%) and performed in 9 vessels (47.4%) as the only treatment method. Conclusions CE is rare in AMI, and AF is the most critical cause which should draw our attention. The Japan NCVC criteria were a helpful diagnostic tool for CE with high accuracy, but the distal coronary artery embolism with moderate atherosclerosis might be overlooked. Thrombus aspiration was the preferred treatment to remove thrombus and restore coronary flow to improve prognosis.https://doi.org/10.1186/s40001-025-02914-8Coronary arteryEmbolismMyocardial infarctionAtrial fibrillationDiagnosisTreatment
spellingShingle Shufu Chang
Rende Xu
Yuxiang Dai
Chenguang Li
Hao Lu
Qing Qin
Jianying Ma
Juying Qian
Junbo Ge
Coronary embolism resulting in myocardial infarction: diagnosis and treatment
European Journal of Medical Research
Coronary artery
Embolism
Myocardial infarction
Atrial fibrillation
Diagnosis
Treatment
title Coronary embolism resulting in myocardial infarction: diagnosis and treatment
title_full Coronary embolism resulting in myocardial infarction: diagnosis and treatment
title_fullStr Coronary embolism resulting in myocardial infarction: diagnosis and treatment
title_full_unstemmed Coronary embolism resulting in myocardial infarction: diagnosis and treatment
title_short Coronary embolism resulting in myocardial infarction: diagnosis and treatment
title_sort coronary embolism resulting in myocardial infarction diagnosis and treatment
topic Coronary artery
Embolism
Myocardial infarction
Atrial fibrillation
Diagnosis
Treatment
url https://doi.org/10.1186/s40001-025-02914-8
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