Abstract 11383: Risk of Stroke Among Patients With Left Ventricular Thrombus Undergoing Percutaneous Coronary Intervention: A 5-Year Retrospective Review Using Real-World Data

Abstract

Introduction: Left ventricular thrombus (LVT) is a well-established risk for ischemic stroke. Nevertheless, it remains uncertain if percutaneous coronary intervention (PCI) in the setting of LVT further augments the risk of stroke. Therefore, in this study, we evaluated the risk of stroke among patients with LVT undergoing PCI. Methods: This retrospective observational cohort study included the patients admitted with LVT to Heart Hospital in Qatar between April 1, 2015 and March 31, 2020. The study population was divided into two groups: (1) patients with LVT who underwent PCI; (2) patients with LVT who did not undergo PCI. The primary outcome evaluated was stroke during the index admission, and the secondary outcomes were in-hospital mortality, all-cause mortality, and stroke at 12 months post discharge. Logistic regression was used to determine the risk of stroke associated with PCI among patients with LVT. A p<0.05 indicated statistical significance. Results: Of the 210 patients included, 119 underwent PCI, while 91 patients did not undergo PCI. Most of the patients were Asian (67%), male (96%) with a mean age of 56 yearsIschemic cardiomyopathy was the main etiology of LVT in both groups (96% in the PCI group and 80% in non-PCI group). Around 70% of the patients in the PCI group underwent intervention to the left anterior descending artery. During the index admission, stroke among patients with LVT did not differ between the PCI and non-PCI groups (5% versus 3.3%; odds ratio (OR) 1.6, 95% confidence interval (CI) 0.34-6.4, p=0.539; adjusted OR 0.9, 95% CI 0.09-10.6, p=0.968. Similarly, in-hospital mortality, all-cause mortality, and stroke at 12 months did not differ between the study groups. Conclusion: Performing PCI among patients with LVT was not associated with increased risk of stroke during admission or at 12 months in comparison to patients who did not undergo PCI, which may reassure cardiologists to safely perform PCI among patients with LVT and defer delaying the procedure among patients with acute coronary syndrome due to presumed risk of stroke.