Clinical Characteristics and Risk Factors of Left Ventricular Thrombus after Acute Myocardial Infarction

Abstract

Background:Left ventricular thrombus (LVT) is reported to be a common complication in acute myocardial infarction (AMI) patients. And it has the potential to cause systemic embolism. This retrospective study was to present the current situation of LVT in clinical practice, as well as to evaluate the clinical characteristics and the risk factors of LVT after AMI.Methods:LVT cases (n = 96) were identified from 13,732 AMI (non-ST elevation myocardial infarction was excluded) patients in Fuwai Hospital's electronic medical records system from January 2003 to January 2013. The controls (n = 192) were gender- and age-matched AMI patients without LVT during this period. A conditional logistic regression (fitted by the Cox model) was performed to identify the independent risk factors.Results:The incidence of LVT after AMI was 0.7%. Univariate analysis indicated that the anterior myocardial infarction (especially extensive anterior myocardial infarction), lower left ventricular ejection fraction (LVEF), LVEF ≤40%, severe regional wall motion abnormalities (RWMA), pericardial effusion, and left ventricular aneurysm were all related to LVT after AMI. The independent risk factors obtained from the conditional logistic regression analysis were lower LVEF (odds ratio (OR) = 0.891, 95% confidence interval (CI): 0.828–0.960), extensive anterior myocardial infarction (OR = 6.403, 95% CI: 1.769–23.169), severe RWMA (OR = 7.348, 95% CI: 1.323–40.819), and left ventricular aneurysm (OR = 6.955, 95% CI: 1.673–28.921).Conclusions:This study indicated that lower LVEF, extensive anterior myocardial infarction, severe RWMA, and left ventricular aneurysm were independent risk factors of LVT after AMI. It also suggested that further efforts are needed for the LVT diagnosis after AMI in clinical practice.

Value of the platelet-to-lymphocyte ratio in the prediction of left ventricular thrombus in anterior ST-elevation myocardial infarction with left ventricular dysfunction

“…Regrettably, there was no statistical significance after multivariate analysis. Moreover, consistent with prior studies [27,28], we also demonstrated an independent association between left ventricular aneurysm and LVT. Interestingly, sixteen patients were diagnosed with ventricular aneurysm, 93.75% (15/16) of whom had LVT.…”

Comprehensive Identification of Key Genes Involved in Development of Diabetes Mellitus-Related Atherogenesis Using Weighted Gene Correlation Network Analysis

“…We downloaded gene expression profiles from the Gene Expression Omnibus (https://www.ncbi.nlm.nih.gov/) (16) to analyze genetic differences between DM and DMCHD. We extracted the data set from the human whole blood gene expression profile of GSE34198 based on GPL6947 (17), which included 33 healthy control samples, 34 CHD samples, 15 DM samples and 15 DMCHD samples. In GSE34198, CHD patients refers to patients who eventually develop acute myocardial infarction and DM refers to type 2 diabetes.…”

Prognostic Relevance of Left Ventricular Thrombus Motility: Assessment by Pulsed Wave Tissue Doppler Imaging

“…Left ventricular thrombi are generally a complication associated with anterior ST-elevation myocardial infarction, dilated cardiomyopathies, or LV aneurysms. 25 -27 Dimensions, shape, grade of homogeneity, and motility of LV thrombi are all characteristics defining the embolic risk and addressing the therapeutic management. 7…”