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Multicenter Study
. 2018 Oct;41(10):1289-1296.
doi: 10.1002/clc.23039. Epub 2018 Oct 16.

Left ventricular thrombosis in acute anterior myocardial infarction: Evaluation of hospital mortality, thromboembolism, and bleeding

Pradhum Ram  1 , Mahek Shah  2 , Natee Sirinvaravong  1 , Kevin Bryan Lo  1 , Shantanu Patil  3 , Brijesh Patel  2 , Byomesh Tripathi  4 , Lohit Garg  2 , Vincent Figueredo  5
Affiliations
Multicenter Study

Left ventricular thrombosis in acute anterior myocardial infarction: Evaluation of hospital mortality, thromboembolism, and bleeding

Pradhum Ram et al. Clin Cardiol. 2018 Oct.

Abstract

Background: Left ventricular thrombosis (LVT) is a well-known complication of acute myocardial infarction, most commonly seen in anterior wall ST-segment elevation myocardial infarction (STEMI). It is associated with systemic thromboembolism.

Hypothesis: Our aim was to evaluate the impact of LVT on in-hospital mortality, thromboembolism, and bleeding in patients with anterior STEMI.

Methods: Data was collected from the Nationwide Inpatient Sample where patients with a primary diagnosis of "Anterior STEMI" [ICD9-CM code 410.1] were included. Comparisons were made between patients with LVT [ICD9-CM code 429.79] vs those without using propensity score matching (PSM).

Results: From 2002 to 2014, there were 157 891 cases of anterior STEMI. Among these, 649 (0.4%) had LVT. Post-PSM, there was no difference in in-hospital mortality between the groups with LVT and without (7.3% vs 8.6%). Thromboembolic event rate was higher with LVT compared to those without LVT (7.3% vs 2.1%). There was no difference in bleeding events between patients with LVT and those without (2.9% vs 3.2%). The baseline average length of stay in the group with LVT was longer than the group without LVT (7.9 ± 6.7 days vs 5.1 ± 6.0 days). The average hospitalization-related costs were also significantly higher among patients with LVT compared to those without (95 598 USD vs 66 641 USD per stay) at baseline.

Conclusion: Among patients hospitalized with anterior STEMI, presence of LVT is associated with increased thromboembolic events, average length of hospital stay and average cost of hospitalization. However, it is not associated with increased in-hospital mortality or bleeding events.

Keywords: anterior STEMI; cardiac thrombosis; left ventricular thrombus; thromboembolism.

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Conflict of interest statement

The authors declare no potential conflict of interests.

Figures

Figure 1
Figure 1
Annual trends in primary and secondary endpoints among patients with an anterior ST‐segment elevation myocardial infarction (STEMI) depending on the presence of left ventricular thrombosis (LVT)
See this image and copyright information in PMC

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References

    1. Asinger RW, Mikell FL, Elsperger J, Hodges M. Incidence of left‐ventricular thrombosis after acute transmural myocardial infarction. Serial evaluation by two‐dimensional echocardiography. N Engl J Med. 1981;305(6):297‐302. 10.1056/NEJM198108063050601. - DOI - PubMed
    1. Halperin JL, Fuster V. Left ventricular thrombus and stroke after myocardial infarction: toward prevention or perplexity? J Am Coll Cardiol. 1989;14(4):912‐914. - PubMed
    1. Weinsaft JW, Kim J, Medicherla CB, et al. Echocardiographic algorithm for post‐myocardial infarction LV thrombus: a gatekeeper for thrombus evaluation by delayed enhancement CMR. JACC Cardiovasc Imaging. 2016;9(5):505‐515. 10.1016/j.jcmg.2015.06.017. - DOI - PMC - PubMed
    1. Abdelmoneim SS, Pellikka PA, Mulvagh SL. Contrast echocardiography for assessment of left ventricular thrombi. J Ultrasound Med. 2014;33(8):1337‐1344. 10.7863/ultra.33.8.1337. - DOI - PubMed
    1. Delewi R, Zijlstra F, Piek JJ. Left ventricular thrombus formation after acute myocardial infarction. Heart. 2012;98(23):1743‐1749. 10.1136/heartjnl-2012-301962. - DOI - PMC - PubMed

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