Marzenna Zielinska1, Krzysztof Kaczmarek. 1. Clinic of Cardiology, I Department of Cardiology and Cardiac Surgery, Medical University, 1/3 Sterlinga Str., 91-425 Lodz, Poland. mzielinska@daad-alumni.de
Abstract
BACKGROUND: Left ventricular (LV) thrombus related to acute myocardial infarction (AMI) has been rarely diagnosed since primary stenting has become the routine treatment. The salvage of myocardium at risk is considered as a reason for low frequency of this complication. The impact of glycoprotein IIb/IIIa inhibitors on LV thrombus formation remains unknown. This study investigated the relationship between abciximab treatment and presence of LV thrombus in the first few days after primary stenting. METHODS AND RESULTS: A total of 3,078 patients with AMI, who underwent successful primary stenting, were retrospectively analyzed. There were 1,614 patients, who received abciximab and 1,414 treated without it. All patients received aspirin and clopidogrel. LV thrombus was diagnosed by two-dimensional echocardiography within 3-5 days after invasive treatment. This complication appeared equally frequently in both the abciximab and no-abciximab group (2.9% vs. 2.1%, respectively). According to results of multiple log-regression analysis, both groups did not differ in predictors of thrombus formation, such as infarct size and degree of LV dysfunction. Treatment with abciximab was not proved to be an independent predictor of LV thrombus absence. CONCLUSION: Abciximab does not have a direct influence on LV thrombus formation in the early period of AMI.
BACKGROUND: Left ventricular (LV) thrombus related to acute myocardial infarction (AMI) has been rarely diagnosed since primary stenting has become the routine treatment. The salvage of myocardium at risk is considered as a reason for low frequency of this complication. The impact of glycoprotein IIb/IIIa inhibitors on LV thrombus formation remains unknown. This study investigated the relationship between abciximab treatment and presence of LV thrombus in the first few days after primary stenting. METHODS AND RESULTS: A total of 3,078 patients with AMI, who underwent successful primary stenting, were retrospectively analyzed. There were 1,614 patients, who received abciximab and 1,414 treated without it. All patients received aspirin and clopidogrel. LV thrombus was diagnosed by two-dimensional echocardiography within 3-5 days after invasive treatment. This complication appeared equally frequently in both the abciximab and no-abciximab group (2.9% vs. 2.1%, respectively). According to results of multiple log-regression analysis, both groups did not differ in predictors of thrombus formation, such as infarct size and degree of LV dysfunction. Treatment with abciximab was not proved to be an independent predictor of LV thrombus absence. CONCLUSION:Abciximab does not have a direct influence on LV thrombus formation in the early period of AMI.
Authors: Elliott M. Antman; Daniel T. Anbe; Paul Wayne Armstrong; Eric R. Bates; Lee A. Green; Mary Hand; Judith S. Hochman; Harlan M. Krumholz; Frederick G. Kushner; Gervasio A. Lamas; Charles J. Mullany; Joseph P. Ornato; David L. Pearle; Michael A. Sloan; Sidney C. Smith; Joseph S. Alpert; Jeffrey L. Anderson; David P. Faxon; Valentin Fuster; Raymond J. Gibbons; Gabriel Gregoratos; Jonathan L. Halperin; Loren F. Hiratzka; Sharon Ann Hunt; Alice K. Jacobs; Joseph P. Ornato Journal: J Am Coll Cardiol Date: 2004-08-04 Impact factor: 24.094