BACKGROUND: There are limited data referring to the incidence of left ventricle (LV) thrombus formation after successful primary percutaneous coronary intervention (PCI) with stenting, which is now the treatment of choice in patients with acute myocardial infarction (AMI). Previously reported results were often based on low or heterogeneous patient populations. METHODS: To evaluate the prevalence of LV thrombus in the early period of AMI, 2,911 patients who had undergone successful primary stenting were retrospectively studied. Baseline demographic characteristics, angiographic findings, and antiplatelet treatment were analyzed to find predictors of thrombus formation. LV thrombus was diagnosed by 2-dimensional echocardiography within 3 to 5 days after PCI. RESULTS: This complication was detected in 73 patients (2.5%). Patients with thrombus and patients without it were at the same age and had diabetes mellitus, prior myocardial infarction, and lipid disorders at the same frequency. The extent of coronary artery disease was similar in both groups. The incidence of LV thrombi was similar in patients treated with and without glycoprotein IIb/IIIa inhibitors (2.02% vs 2.9%, NS). According to results of multiple log-regression analysis, the presence of LV thrombus was strongly associated with anterior AMI, ejection fraction <40%, and previous hypertension. CONCLUSIONS: The incidence of left ventricular thrombus early after AMI is very low if primary PCI with stenting is successful, probably due to the salvage of myocardium at risk. Localization of AMI and the size of myocardium damage remain the most important independent predictors of LV thrombus formation irrespective of various treatments.
BACKGROUND: There are limited data referring to the incidence of left ventricle (LV) thrombus formation after successful primary percutaneous coronary intervention (PCI) with stenting, which is now the treatment of choice in patients with acute myocardial infarction (AMI). Previously reported results were often based on low or heterogeneous patient populations. METHODS: To evaluate the prevalence of LV thrombus in the early period of AMI, 2,911 patients who had undergone successful primary stenting were retrospectively studied. Baseline demographic characteristics, angiographic findings, and antiplatelet treatment were analyzed to find predictors of thrombus formation. LV thrombus was diagnosed by 2-dimensional echocardiography within 3 to 5 days after PCI. RESULTS: This complication was detected in 73 patients (2.5%). Patients with thrombus and patients without it were at the same age and had diabetes mellitus, prior myocardial infarction, and lipid disorders at the same frequency. The extent of coronary artery disease was similar in both groups. The incidence of LV thrombi was similar in patients treated with and without glycoprotein IIb/IIIa inhibitors (2.02% vs 2.9%, NS). According to results of multiple log-regression analysis, the presence of LV thrombus was strongly associated with anterior AMI, ejection fraction <40%, and previous hypertension. CONCLUSIONS: The incidence of left ventricular thrombus early after AMI is very low if primary PCI with stenting is successful, probably due to the salvage of myocardium at risk. Localization of AMI and the size of myocardium damage remain the most important independent predictors of LV thrombus formation irrespective of various treatments.
Authors: Keaton S Smetana; Jessie Dunne; Kevin Parrott; George A Davis; Amy C Schmelzer Collier; Mary Covell; Susan Smyth Journal: J Thromb Thrombolysis Date: 2017-11 Impact factor: 2.300
Authors: Adam M Garber; Robert J Mentz; Hussein R Al-Khalidi; Linda K Shaw; Mona Fiuzat; Christopher M O'Connor; Eric J Velazquez Journal: J Thromb Thrombolysis Date: 2016-04 Impact factor: 2.300
Authors: Aiham Albaeni; Khaled Chatila; Hind A Beydoun; May A Beydoun; Mohammad Morsy; Wissam I Khalife Journal: Int J Cardiol Date: 2019-07-23 Impact factor: 4.164