Evidence-Based Recommendations

Abstract

One of the potential complications of acute myocardial infarction is left ventricular thrombus (LVT). The incidence of LVT following acute myocardial infarction has decreased dramatically with early invasive reperfusion techniques or fibrinolysis. However, the risk of LVT formation remains significant and is associated with an increased risk of systemic embolism, stroke, cardiovascular events, and even death. Current guidelines indicate that dual antiplatelet therapy and anticoagulation therapy for at least 3 months can reduce the risk of these events. While vitamin K antagonist is the preferred oral anticoagulant, there is growing evidence to support the use of direct-acting oral anticoagulants in LVT management. Cardiac magnetic resonance has shown the highest diagnostic accuracy for LVT assessment, followed by echocardiography with contrast agents. This article serves as a general review of the pathophysiology, diagnosis, and management of LVT.

Chinese expert consensus on anti-thrombotic therapy for pan-vascular diseases (2023 edition)

“…Imaging should be conducted on the third month to examine the status of thrombus dissolution. Based on these findings, along with consideration of the patient’s risk of bleeding and the risk of recurrence of LVT, a decision on whether to continue anticoagulation can be made [111,115] .…”