{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T11:54:28Z","timestamp":1792842868685,"version":"4.5.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,3]]},"abstract":"\n Background<\/jats:title>\n Coronary embolism (CE) is an underrecognized cause of acute myocardial infarction, and limited data exist comparing atrial fibrillation\u2013related CE (AF CE) with CE from other causes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n We conducted the first multicenter study in this challenging setting (NCT06948240). We retrospectively included 489 patients diagnosed with CE across 10 hospitals. CE was diagnosed using Shibata criteria. Patients were classified into AF CE and non\u2010AF CE groups.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 241 patients (49%) had AF CE. Distinctive angiographic features were reported in patients with AF CE: less proximal coronary obstruction (34% versus 46%,\n P<\/jats:italic>\n =0.04), lower percutaneous coronary intervention rates (34% versus 45%,\n P<\/jats:italic>\n =0.03), more frequent initial thrombolysis in myocardial infarction 0 flow (85% versus 70%,\n P<\/jats:italic>\n =0.01), and less final thrombolysis in myocardial infarction 3 flow (52% versus 76%,\n P<\/jats:italic>\n <0.001). In\u2010hospital composite outcome occurred in 44% of patients with AF CE versus 25% in patients without AF CE (\n P<\/jats:italic>\n <0.001), including higher mortality (14% versus 6%,\n P<\/jats:italic>\n =0.003), heart failure (24% versus 14%,\n P<\/jats:italic>\n =0.002), and cardiogenic shock (14% versus 8%,\n P<\/jats:italic>\n =0.048). Long\u2010term adverse events were also more frequent in AF CE (45% versus 16%,\n P<\/jats:italic>\n <0.001), with higher rates of stroke (9% versus 3%\n P<\/jats:italic>\n =0.02), heart failure (15% versus 5%,\n P<\/jats:italic>\n =0.002), and all\u2010cause mortality (34% versus 11%,\n P<\/jats:italic>\n <0.001). In multivariable models, AF CE was independently associated with worse in\u2010hospital outcomes (odds ratio, 3.3 [95% CI, 1.4\u20138;\n P<\/jats:italic>\n =0.007]) and long\u2010term events (hazard ratio, 2.5 [95% CI, 1.2\u20135;\n P<\/jats:italic>\n =0.01]).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n AF\u2010related CE is associated with distinct angiographic patterns and independently predicts poor outcomes, highlighting the need for refined and tailored strategies in AF CE.<\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.125.045608","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:33:41Z","timestamp":1771590821000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Atrial Fibrillation Versus Nonatrial Fibrillation Coronary Embolism: A Multicenter Study"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2181-0961","authenticated-orcid":false,"given":"Alberto","family":"Vera","sequence":"first","affiliation":[{"name":"Hospital Universitario de Navarra","place":["Pamplona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0668-5171","authenticated-orcid":false,"given":"Arturo","family":"Lanaspa","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Navarra","place":["Pamplona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2830-0171","authenticated-orcid":false,"given":"Jeanne","family":"Varlot","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, CHRU\u2010Nancy","place":["Nancy, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0362-6020","authenticated-orcid":false,"given":"Eduardo","family":"Pozo\u2010Osinalde","sequence":"additional","affiliation":[{"name":"Hospital Universitario Cl\u00ednico San Carlos","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1722-5922","authenticated-orcid":false,"given":"Lidia","family":"Vilches","sequence":"additional","affiliation":[{"name":"Hospital Universitario de la Princesa","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9467-9517","authenticated-orcid":false,"given":"Raquel Ajo","family":"Ferrer","sequence":"additional","affiliation":[{"name":"Instituto de Investigaci\u00f3n Sanitaria y Biom\u00e9dica de Alicante (ISABIAL)","place":["Alicante, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0628-9944","authenticated-orcid":false,"given":"Eva","family":"Jover","sequence":"additional","affiliation":[{"name":"Universidad P\u00fablica de Navarra (UPNA)","place":["Pamplona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adela","family":"Navarro","sequence":"additional","affiliation":[{"name":"Hospital Universitario de Navarra","place":["Pamplona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7562-8677","authenticated-orcid":false,"given":"Pilar","family":"Jim\u00e9nez","sequence":"additional","affiliation":[{"name":"Hospital Universitario Cl\u00ednico San Carlos","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9sar","family":"Jim\u00e9nez\u2010M\u00e9ndez","sequence":"additional","affiliation":[{"name":"Hospital Universitario Puerta del 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