Journal of Clinical Cases

Outcomes Of Intervention Treatment For Concurrent Cardio-Cerebral Infarction: Meta-Analysis

Mohammed Habib, Sommaya Alhout

Department
Department of Cardiology, Alshifa Hospital, Gaza, Palsetine

Corresponding Author: Mohammed Habib and Sommaya Alhout

ABSTRACT

1.1. Background: The concurrent occurrence of acute ischemic stroke and acute myocardial infarction (concurrent Cardio-cerebral infarction) is an extremely rare emergency condition that can be lethal. The causes, prognosis and optimal treatment in these cases is still unclear.
1.2. Methods: We conducted a comprehensive review of five databases, PubMed, Embase, Scopus, Research Gate and Google Scholar on concurrent or simulations and synchronous cardio-cerebral infarction to locate all case reports or case series done on this topic, we analyzed clinical presentations, risk factors, type of myocardial infarction, site of stroke, modified ranking scale at discharge and at 90 days after discharge and treatment options.
1.3. Results: we identified 94 cases of concurrent cardio-cerebral infarction from case reports and series with mean age 62.5±12.6 years. Female 36 patients (38.3%), male 58 patients (61.7%). Median hospital duration 24 hours (0-792 hours). Median admission NIHSS 15 (range 1–30). 29 patients (30.8%) were treated using percutaneous coronary intervention (PCI): PCI with balloon only 9 (9.6%), PCI with aspiration only 1 (3.2%), PCI with Bare metal stent 3 (3.2%), PCI with Drug eluting stent 16 (17%). Treated via Mechanical thrombectomy of cerebral vessels in 24 patients (25.5%). Only 21 (22.3%) were treated combination by both PCI and Mechanical thrombectomy of cerebral vessels. The outcome of 94 patients, the mortality rate at hospital discharge were in 24 patients from 72 patients with mortality rate (33.3%), the mortality rate at 90 days we recorded in 29 patients from 59 patients with mortality rate (49.2%). In patients with combination intervention treatment group: hospital mortality rate was 13.3% and 90-days mortality rate was:23.5% compared with mortality rate in medical treatment (23.5% and 59.5% respectively (P value 0.038 and 0.012 respectively)
1.4. Conclusion: despite its rarity, concurrent cardio-cerebral infarction prognosis is very poor, about third of patients died before discharge and half of patients died at 90 days after stroke. Only 22 % of patients treated by combination of both percutaneous coronary intervention and mechanical thrombectomy. Thus, further studies would be important to outline new possibilities in the management of this emergency condition.