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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.

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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

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