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Left ventricular thrombus after primary angioplasty does not increase risk of systemic thromboembolism

14 Oct 2019

A recent study has detected left ventricular thrombus in <3 percent of patients who underwent primary angioplasty for ST-elevation myocardial infarction (STEMI). No association exists between the presence of left ventricular thrombus and a higher risk of systemic thromboembolism.

A total of 2,608 patients underwent primary angioplasty for STEMI, of whom 1,645 (63 percent) had a transthoracic echocardiogram performed during the index hospital admission. Transthoracic echocardiography detected left ventricular thrombus in 40 patients (2.4 percent).

Those with left ventricular thrombus appeared to be at increased risk of developing atrial fibrillation in the immediate postinfarction period (15 percent vs 5.4 percent; p=0.025).

The primary endpoint of a composite of all-cause mortality, stroke and systemic thromboembolism at 1 year occurred in four (10 percent) patients with left ventricular thrombus and in 146 (9.1 percent) who did not (logistic regression hazard ratio, 0.79, 95 percent CI, 0.23–2.70).

This study recruited and sought to determine clinical outcomes in patients who underwent primary angioplasty for STEMI and had a transthoracic echocardiogram. For the primary endpoint, the authors used a logistic regression, adjusting for minimization variables including age, diabetes mellitus, hypertension and previous stroke, to compare the difference between the presence and absence of left ventricular thrombus.

“Left ventricular thrombus formation is a complication of acute myocardial infarction,” the authors said. “However, the incidence and risk of systemic thromboembolism in the era of primary angioplasty for STEMI is unclear.”

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Most Read Articles
Jairia Dela Cruz, 3 days ago
Metabolic and bariatric surgery (MBS) leads to large and sustained reductions in, and even reversal of, multiple risk factors for future joint disease in adolescents with severe obesity and musculoskeletal pain, according to data from the Teen Longitudinal Assessment of Bariatric Surgery study.
Pearl Toh, 31 Dec 2019
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23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
Pearl Toh, 6 days ago
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