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. 2024 Dec 11;5(4):207-214.
doi: 10.47487/apcyccv.v5i4.430. eCollection 2024 Oct-Dec.

[Clinical, diagnostic and therapeutic profile of patients with left intraventricular thrombus in three high-complexity centers during the period 2000-2022]

[Article in Spanish]
Felipe Lozano Pineda  1   2 , Carolina Cardona Buitrago  1   3 , Santiago Giraldo Ramírez  2 , Jairo Alfonso Gándara Ricardo  1   4 , Edison Muñoz Ortiz  1   4 , Catalina Gallego Muñoz  5 , Juan David Valencia Duque  5 , Edgar Alonso Mejía Guerra  6 , Juan Nicolás Dallos Ferrerosa  1 , Juan Manuel Senior Sánchez  1   7
Affiliations

[Clinical, diagnostic and therapeutic profile of patients with left intraventricular thrombus in three high-complexity centers during the period 2000-2022]

[Article in Spanish]
Felipe Lozano Pineda et al. Arch Peru Cardiol Cir Cardiovasc. .

Abstract
in English, Spanish

Objective: To determine the clinical, diagnostic, and therapeutic profile of patients with left intraventricular thrombus (LVT) in three high-complexity centers in Medellín, Colombia, between January 2000 and January 2022.

Materials and methods: This was an observational and cross-sectional study that included 307 patients with LVT. Hospital records were analyzed to identify the clinical and therapeutic profile, and thrombus resolution and systemic embolism were evaluated. Univariate and bivariate analyses were performed using Fisher's exact test and a logistic regression model.

Results: The prevalence of LVT was 9.75%. In 85% of cases, LVT was diagnosed using transthoracic echocardiography; 75.9% of patients were male, and the median age was 62 years. The most frequent comorbidities were heart failure (95.77%) and hypertension (69.7%).LVT occurred in 27% of cases in the context of acute coronary syndrome (ACS). Low molecular weight heparin (LMWH) was administered in 78.5% of cases, and warfarin was the most commonly used anticoagulant (82.7%). Hemorrhagic complications occurred in 19.2%, mainly gastrointestinal, and 35% of patients achieved thrombus resolution. Systemic embolism developed in 30% of cases, primarily affecting the central nervous system. Overall mortality was 15%.

Conclusions: The prevalence of LVT was 9.75%. Warfarin remains the standard treatment, although alternative therapies are used in special cases. Apical dysfunction was associated with systemic embolism.

Objetivo.: Determinar el perfil clínico, diagnóstico y terapéutico de pacientes con trombo intraventricular izquierdo (TVI) en tres centros de alta complejidad en Medellín, Colombia, entre enero de 2000 y enero de 2022.

Materiales y métodos.: Estudio observacional y transversal que incluyó 307 pacientes con TVI. Se analizaron los registros hospitalarios para identificar el perfil clínico y terapéutico, y se evaluó la resolución del trombo y la embolia sistémica. Se realizaron análisis univariado y bivariado con la prueba exacta de Fisher y un modelo de regresión logística.

Resultados.: La prevalencia de TVI fue 9,75%. El 85% de los casos fueron diagnosticados mediante ecocardiograma transtorácico, el 75,9% fueron hombres y la mediana de edad fue 62 años. Las comorbilidades más frecuentes fueron falla cardiaca (95,77%) e hipertensión arterial (69,7%). El 27% de los TVI ocurrieron en el contexto de un síndrome coronario agudo (SCA). La heparina de bajo peso molecular (HBPM) se administró en el 78,5% y la warfarina fue el anticoagulante más común (82,7%). El 19,2% presentó complicaciones hemorrágicas, principalmente gastrointestinales, y el 35% tuvo resolución del trombo. El 30% desarrolló embolia sistémica, principalmente al sistema nervioso central. La mortalidad fue del 15%.

Conclusiones.: La prevalencia de TVI fue del 9,75%. La warfarina sigue siendo el tratamiento estándar, aunque las terapias alternativas se utilizan en casos especiales. La disfunción apical se asoció con embolismo sistémico.

Keywords: Anticoagulants; Embolism and Thrombosis; Epidemiology; Prognosis.

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Conflict of interest statement

Conflictos de interés: Ninguno por declarar

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