Decoding the link between ischemic stroke and myocardial infarction: a pathophysiological and clinical perspective.

Ling Chen, Senrong Luo, Mingzhu Feng, Ayush Chandra, José Fidel Baizabal-Carvallo, Mohammad Mofatteh, Jiale Wu, Yuankang He, Zhikai Chen, Xiaoru Zeng, Junrong Tu, Xuejun Wang, Xuxing Liao

Journal: European journal of medical research 2025;30(1):984

PMID: 41102842

Abstract

Ischemic stroke and myocardial infarction (MI) are among the leading causes of morbidity and mortality globally. Recent research has increasingly highlighted the significant interrelation between these two vascular events, emphasizing shared pathophysiological mechanisms, overlapping risk factors, and complex clinical outcomes. This review explores the multifaceted relationship between ischemic stroke and MI, focusing on their common underlying mechanisms, including atherosclerosis, thromboembolism, inflammation, and endothelial dysfunction. Both conditions often co-occur due to their shared risk factors, such as hypertension, diabetes, and smoking, leading to compounded health risks for affected individuals. This review aims to synthesize current evidence on the epidemiological, pathophysiological, and clinical interrelationships between ischemic stroke and myocardial infarction, highlighting practical clinical implications and areas for future research. Although ischemic stroke and myocardial infarction primarily affect distinct organ systems, atypical presentations and shared systemic effects can occasionally complicate diagnosis. Cardiac complications are common in acute ischemic stroke, while stroke-like symptoms may arise in patients with acute MI, especially when silent infarctions occur. This diagnostic challenge underscores the need for advanced neuroimaging and cardiac imaging modalities, alongside biomarkers like D-dimer, BNP, and troponins, to enhance early detection and guide therapeutic decisions. Therapeutic strategies for patients with both conditions must be comprehensive, combining acute management with long-term secondary prevention. While antiplatelet therapy, thrombolysis, and anticoagulation are essential in the acute phase, long-term management involves a focus on controlling cardiovascular risk factors, such as blood pressure and cholesterol, and promoting lifestyle modifications. The role of interdisciplinary care-particularly collaboration between cardiology and neurology-is essential for improving outcomes and minimizing complications. The intersection of ischemic stroke and MI presents significant clinical challenges but also opportunities for enhanced patient management. Integrated diagnostic approaches, personalized treatments, and further research into molecular mechanisms are vital for improving the prognosis of individuals affected by both conditions.

© 2025. The Author(s).

Address: Internal Medicine-Cardiovascular Department, Foshan Sanshui District People's Hospital (Sanshui Hospital, Zhujiang Hospital, Southern Medical University), Foshan City, Guangdong Province, China.; Graduate School, Guangdong Medical University, Zhanjiang, Guangdong Province, China.; Department of Neurosurgery, First People's Hospital of Foshan, Foshan, 528000, Guangdong Province, China.; Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital (Sanshui Hospital, Zhujiang Hospital, Southern Medical University), Foshan, Guangdong Province, China.; Department of Clinical Medicine, Tianjin Medical University, Tianjin, People's Republic of China.; Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA.; Department of Sciences and Engineering, University of Guanajuato, León, Mexico.; School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.; School of Medicine, Shaoguan University, Shaoguan, Guangdong Province, China.; Foshan Sanshui District People's Hospital (Sanshui Hospital, Zhujiang Hospital, Southern Medical University), Foshan, China.; Department of Neurosurgery, First People's Hospital of Foshan, Foshan, 528000, Guangdong Province, China.; Internal Medicine-Cardiovascular Department, Foshan Sanshui District People's Hospital (Sanshui Hospital, Zhujiang Hospital, Southern Medical University), Foshan City, Guangdong Province, China. [email protected].; Department of Neurology and Advanced National Stroke Center, Foshan Sanshui District People's Hospital (Sanshui Hospital, Zhujiang Hospital, Southern Medical University), Foshan, Guangdong Province, China. [email protected].; Department of Neurosurgery, First People's Hospital of Foshan, Foshan, 528000, Guangdong Province, China. [email protected].
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