Portal de investigación
Prediction of left ventricular thrombus after myocardial infarction: a cardiac magnetic resonance-based prospective registry
Fecha de publicación:
Fecha Ahead of Print:
Autores de INCLIVA
Participantes ajenos a INCLIVA
- Pérez Del Villar C
- Gavara J
- Lopez-Lereu MP
- Monmeneu JV
- Herrera Flores C
- Domenech-Ximenos B
- Moratal D
- Ortiz-Pérez JT
- Bayes-Genis A
- Rodríguez-Palomares JF
- Sánchez PL
Grupos y Plataformas de I+D+i
Abstract
Background: Left ventricular thrombus (LVTh) is a severe complication after ST-segment elevation myocardial infarction (STEMI). Objectives: We aim to predict LVTh occurrence by cardiac magnetic resonance (CMR) using clinical, echocardiographic, and electrocardiographic (ECG) variables readily available at admission. Methods: We included 590 reperfused STEMI patients who underwent early (1-week) and/or late (6-month) CMR in our institution. Baseline clinical, echocardiographic (left ventricular ejection fraction -LVEF-) and ECG data (summatory of ST-segment elevation -sum-STE- and Q-wave and residual ST-elevation >1 mm -Q-STE-) during admission were registered. Multivariate binary logistic regression models and receiver operating characteristic curves were computed for LVTh prediction. Results: LVTh was detected by CMR in 43 (7.3 %) patients and was predicted by previous chronic coronary syndrome (CCS, HR 4.74 [1.82-12.35], p = 0.001), anterior STEMI (HR 10.93 [2.47-48.31], p = 0.002), LVEF (HR 0.96 [0.93-0.99] per %, p = 0.008), maximum sum-STE (HR 1.04 [1.01-1.07] per mm, p = 0.04), and Q-STE (HR 1.31 [1.08-1.6] per lead, p = 0.008). High-risk patients with both major (anterior STEMI and Q-STE in >= 1 leads) and 1-3 minor (CCS, maximum sum-STE >10 mm, LVEF <50%) factors showed the highest LVTh risk (19.6 % within 6 months). The model showed excellent discrimination ability (area under the curve=0.85 [0.81-0.9], p < 0.001). Simplified 4-variable (excluding sum-STE) and 3-variable (also excluding CCS) risk scores showed similar discrimination ability and were externally validated. Conclusions: LVTh within 6 months post-STEMI can be predicted using pre-discharge clinical (anterior infarction and CCS), echocardiographic (LVEF), and ECG (sum-STE and Q-STE) data. Our results can help select patients who should undergo CMR after STEMI for LVTh detection.
Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.
Datos de la publicación
- ISSN/ISSNe:
- 0953-6205, 1879-0828
- Tipo:
- Article
- Páginas:
- 104-112
- PubMed:
- 39384454
European Journal of Internal Medicine ELSEVIER SCIENCE BV
Citas Recibidas en Web of Science: 1
Documentos
Filiaciones
Keywords
- Left ventricular thrombus; ST-segment elevation myocardial infarction; Cardiac magnetic resonance; Left ventricular ejection fraction; Residual ST-segment elevation; Summatory of ST-segment elevation
Financiación
Proyectos y Estudios Clínicos
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CONTRATOS JUAN RODÉS
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CONTRATOS RIO HORTEGA
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Cita
Prediction of left ventricular thrombus after myocardial infarction: a cardiac magnetic resonance-based prospective registry. Bertolin C, Marcos V, Merenciano H, Perez N, Pérez Del Villar C, Gavara J, Lopez MP et al. European Journal of Internal Medicine. 2025 enero 01. 131104-112. DOI:10.1016/j.ejim.2024.09.015. PMID:39384454.
