Objective Recurrence of left ventricular thrombus (LVT) is a common outcome after LVT in acute myocardial infraction (AMI), which causes a new circle of alerting thromboembolism. This study aimed to compare different impact of surgical removal, anticoagulation, thrombolysis therapy and PCI on the recurrence of LVT respectively.
Methods We retrospectively assessed all cases with LVT after AMI in Beijing Fuwai Hospital from January 2007 to February 2012. During this period, 8220 patients were diagnose with STEMI, 82 of which had a definitive diagnosis of LVT, detected by echocardiography, Left ventricular angiography, CT, MRI or operative findings. In this study, we analysed the baseline of clinical characteristics of the patients. Also, we studied the different impact on the disappearance, the recurrence and the cardiac embolism of LVT of the four therapeutic groups, respectively.
Results The incidence of LVT after AMI is 0.998% in this study, 6.1%(5/82) had reoccurred after disappearance, while 4.9%(4/82) had resulted in thromboembolism. 2 patients died, one was for thromboembolism, and the other was due to severe heart failure. The baseline of clinical characteristics, as well as the incidence of thromboembolism, had no significant difference. However, 3 out of the 5 reoccurred thrombus had been treated by Aneurysm resection (p = 0.40), while other groups had no such difference.
Conclusions The incidence of LVT in this study is far lower than other prospective researches, which may imply that clinicians’ attention on LVT is not enough. This study also suggests that operative treatment, though possibly reduce cardiac embolism in LVT after AMI as other research demonstrated, may induce a high risk of newly appearance of LVT due to its iatrogenic trauma. So the suggested anticoagulation therapy should not end with surgical removal in LVT patients after AMI.