Simultaneous Cardio-Cerebral Infarction - A Meta-Analysis.

Abstract

BACKGROUND: Cardiocerebral infarction (CCI), which involves the simultaneous occurrence of acute ischemic stroke (AIS) and acute myocardial infarction (AMI), has a reported incidence of 0.0009%. Treatment of CCI presents a dilemma to physicians as both conditions are time critical. Despite the need for standardised treatment protocols, published data is sparse. METHODS: Four databases, Pubmed, Embase, Scopus and Google Scholar were searched until 25 August 2020. A title and abstract sieve, full-text review and extraction of data were conducted independently by three authors. RESULTS: 44 cases of CCI were identified from 37 case reports and series. 15 patients (34.1%) were treated using percutaneous coronary intervention (PCI) with stent, eight patients (18.2%) were treated with a PCI without stent, ten patients (22.7%) were treated via a cerebral vessel thrombectomy, eight patients (18.2%) were treated via a thrombectomy of a coronary vessel. For medications, 20 patients (45.5%) were treated with thrombolytics, ten patients (22.7%) were treated with anticoagulants, eight patients (18.2%) were treated with antiplatelets and 11 patients (25.0%) were treated with anticoagulants and antiplatelets. Of 44 patients, ten patients died, and nine of those were due to cardiac causes. Among the 44 patients, days to death was observed to be a median of 2.0 days (IQR: 1.5, 4.0). The modified Rankin Score (mRS) was measured in nine patients, with a median score of 2.0 (IQR: 1.0, 2.5) being reported. CONCLUSION: The condition of CCI has substantial morbidity and mortality, and further studies are needed to examine the optimal diagnostic and treatment strategies of these patients.