Abstract

INCIDENCE, PREDICTORS AND COURSE OF LEFT VENTRICULAR THROMBUS IN INDIAN PATIENTS SURVIVING TO DISCHARGE AFTER ANTERIOR WALL MYOCARDIAL INFARCTION

Author(s): Sajeev Chakanalil Govindan, Ankur Kamra, Haridasan Vellani

BACKGROUND To prospectively estimate the incidence of left ventricular (LV) thrombus over one-year follow-up in patients presenting with anterior wall myocardial infarction (AWMI) and to identify the predictors of LV thrombus, to study the course of LV thrombus including clinically evident thrombo-embolic manifestations over a one-year period in Indian population. METHODS Two hundred patients with first AWMI were prospectively and consecutively enrolled. At the time of hospitalization, key demographic and clinical characteristics were collected along with echocardiographic data. Patients were followed up for development or change in existing LV thrombus and thromboembolic event. RESULTS Incidence of LV thrombus was 6.5%. The mean platelet volume and LV wall motion score index (LVWMSI) were significantly higher in LV thrombus patients in comparison to non-LV thrombus patients. Baseline ejection fraction (EF), mean mitral E wave deceleration time (MDT) and mean mitral propagation velocity (MVP) were significantly lower in LV thrombus patients. At oneyear follow-up, 30.76% patients showed disappearance of thrombus, 46.15% showed decrease in size and 23.07% showed no change in size while 15.38% patients showed embolic events. CONCLUSIONS High MPV at admission, low baseline EF, high LVWMSI, low baseline MDT and low MVP are independent predictors of LV thrombus. Moreover, patients undergoing primary PTCA have decreased risk of LV thrombus.