Prognosis and New Predictors of Early Left-Ventricular Thrombus Following ST-Elevation Myocardial Infarction
Qian Zhang,1 Zhongfan Zhang,1 Lina Jin,2 Chengbing Wang,3 Haikuo Zheng,1 Shouping Li,1 Miao Yu,1 Daoyuan Si,1 Wenqi Zhang1 1Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Dise...
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2021
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| Acceso en línea: | https://doaj.org/article/4051426b6ced4b399e15624d7d7de5c4 |
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| Sumario: | Qian Zhang,1 Zhongfan Zhang,1 Lina Jin,2 Chengbing Wang,3 Haikuo Zheng,1 Shouping Li,1 Miao Yu,1 Daoyuan Si,1 Wenqi Zhang1 1Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Disease, Changchun, People’s Republic of China; 2Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, People’s Republic of China; 3Department of Neurology, China-Japan Union Hospital of Jilin University, Changchun, Jilin, People’s Republic of ChinaCorrespondence: Daoyuan Si;Wenqi ZhangDepartment of Cardiology, China-Japan Union Hospital of Jilin University, Xiantai Street No. 126, Changchun, Jilin, People’s Republic of ChinaTel +86 135 78949866; +86 136 44407485Fax +86 431 84995233; +86 431 84995259Email sidaoyuan@jlu.edu.cn; wenqi@jlu.edu.cnObjective: In the current era of primary percutaneous coronary intervention (PPCI), the prognosis of the left ventricular thrombus (LVT) is not well assessed.Methods: We performed a retrospective, single-center study of 1305 consecutive ST-segment-elevation myocardial infarction (STEMI) patients treated with PPCI. During a mean period of 27 months of follow-up, the major adverse cardiovascular and cerebrovascular events (MACCE) were recorded.Results: The incidence of LVT (n = 47) was 3.60%. The independent risk factors of LVT included anterior STEMI, left ventricular (LV) aneurysm, reduced LV ejection fraction (LVEF), dilated LV end-diastolic dimension (LVEDD), and delayed door-to-balloon time (DTBT). During follow-up, LVT was an independent risk factor for MACCE [hazard ratio (HR)=3.46; 95% confidence interval (CI) = 2.23– 3.38; P < 0.01]. Patients with LVT were more likely to have the following complications: heart failure (P < 0.001), embolic events (P = 0.034), and all-cause mortality (P = 0.020). Notably, the regression of LVT was not independently associated with those three adverse events (P > 0.05).Conclusion: In the era of PPCI, the presence of early LVT following STEMI was associated with adverse events. Furthermore, the prognosis of patients with LVT did not improve even if the LVT regressed. LVT was likely a generalized indicator of impaired cardiac performance, rather than the cause. This indicated that prophylactic therapy and identifying individuals with a high risk of developing LVT were of substantial importance.Keywords: left ventricular thrombus, ST-segment elevation myocardial infarction, prognosis, risk factors |
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