Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2020 Jan 15:299:1-6.
doi: 10.1016/j.ijcard.2019.07.070. Epub 2019 Jul 23.

In-hospital left ventricular thrombus following ST-elevation myocardial infarction

Aiham Albaeni  1 , Khaled Chatila  2 , Hind A Beydoun  3 , May A Beydoun  4 , Mohammad Morsy  2 , Wissam I Khalife  2
Affiliations
Multicenter Study

In-hospital left ventricular thrombus following ST-elevation myocardial infarction

Aiham Albaeni et al. Int J Cardiol. .

Abstract

Background: In-hospital left ventricular (LV) thrombus following acute ST-elevation myocardial infarction (STEMI) has not been evaluated on a national scale and was the focus of this investigation.

Methods: We used the 2003 to 2013 Nationwide Inpatient Sample database to identify adults ≥18 years old with a principal diagnosis code of ST-elevation myocardial infarction. Patients were divided into two groups defined by the presence or absence of LV thrombus. Clinical characteristics and in-hospital outcomes were studied using relevant statistics. Multiple linear and logistic regression models were conducted to identify factors associated with LV thrombus.

Results: Of 1,035,888 STEMI patients hospitalized in the U. S from 2003 to 2013, 1982 (0.2%) developed acute in-hospital LV thrombus. Compared to no LV thrombus, patients with LV thrombus were more likely to have in-hospital complications; acute ischemic and hemorrhagic stroke, acute renal failure, gastrointestinal bleed, cardiogenic shock, in-hospital cardiac arrest and mortality. They also had longer mean length of stay and higher hospital charges. Factors associated with LV thrombus included: anterior/anterolateral STEMI, acute or chronic heart failure with reduced ejection fraction, atrial fibrillation, LV aneurysm, Left heart valvular disease, acute or chronic deep venous thrombosis/pulmonary embolism and alcohol abuse. Patients with LV thrombus were less likely to be female [AOR 0.66, 95% CI (0.51-0.84)].

Conclusion: The identification of factors associated with early development of LV thrombus following STEMI, will help direct resources for specific high-risk group and prompt cost-effective therapies. Gender variability in LV thrombus development warrants further investigations.

Keywords: Gender variation; In-hospital complications; Left ventricular thrombus; Resource utilization; ST-elevation myocardial infarction.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Statement: Aiham Albaeni, Khaled Chatila, Hind A. Beydoun, May A. Beydoun, Mohammad Morsy, and Wissam I. Khalife declare no conflict of interest.

Figures

Fig. 1:
Fig. 1:
Proportion of LV thrombus case per 10,000 cases of ST-elevation myocardial infarction by gender.
See this image and copyright information in PMC

References

    1. Zhang Q, Wang CM, Shi ST, Chen H, Zhou YJ. Relationship of left ventricular thrombus formation and adverse outcomes in acute anterior myocardial infarction in patients treated with primary percutaneous coronary intervention. Clin Cardiol 2019; 42:69–75. - PMC - PubMed
    1. Bourezg A, Bochaton T, Mewton N, et al. Atrial fibrillation, intra-ventricular thrombus, and other anticoagulant indications relationship with adverse outcomes in acute anterior myocardial infarction patients. J cardiol 2018; 72:277–283. - PubMed
    1. Maniwa N, Fujino M, Nakai M, et al. Anticoagulation combined with antiplatelet therapy in patients with left ventricular thrombus after first myocardial infarction. Eur Heart J 2018; 39:201–208. - PubMed
    1. Vaitkus PT, Barnathan ES. Embolic potential, prevention and management of mural thrombus complicating anterior myocardial infarction: a meta-analysis. J Am Coll Cardiol 1993; 22:1004–1009. - PubMed
    1. Pöss J, Desch S, Eitel C, de Waha S, Thiele H, Eitel I. Left Ventricular Thrombus Formation After ST-Segment-Elevation Myocardial Infarction: Insights from a Cardiac Magnetic Resonance Multicenter Study. Circ Cardiovasc Imaging 2015;8: e 003417. - PubMed

Publication types

MeSH terms