Coronary Artery DiseaseIncidence and Predictors of Early Left Ventricular Thrombus After ST-Elevation Myocardial Infarction in the Contemporary Era of Primary Percutaneous Coronary Intervention
Section snippets
Methods
We retrospectively analyzed 1,059 patients urgently transferred for pPCI to Kings College Hospital with a diagnosis of STEMI. Kings College Hospital is a tertiary referral center with a busy and mature (>10 years), 24 hours, 7 days per week pPCI service. Patients were included when they fulfilled the diagnostic criteria for STEMI: characteristic symptoms of myocardial ischemia in association with persistent electrocardiographic ST elevation and subsequent release of biomarkers of myocardial
Results
A total of 1,059 subjects with STEMI underwent pPCI at Kings College Hospital in the study period. Patients were enroled from January 1, 2009 to August 31, 2012. The data were analyzed retrospectively. The mean age of the total population was 62 ± 13 years, and 26% of the patients were women.
All patients underwent 2-dimensional TTE. LVT was confidently confirmed in 25 cases (2%) and excluded in 885 cases (84%), and in the remaining 149 patients (14%), a contrast study was performed to clarify
Discussion
In this large cohort of patients presenting with STEMI treated with pPCI, the incidence of LVT is significantly reduced (4%) compared with data from the pre-PCI era. This may be due to an early and aggressive reperfusion strategy and to the use of modern contrast echo technology to improve the diagnosis of LVT and eliminate false positives. Predictors of LVT comprise reduced EF, anterior location of MI, and the use of GP IIb/IIIa inhibitors.
In the context of STEMI, prolonged ischemia results in
Disclosures
The authors have no conflicts of interest to disclose.
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