Portal de investigación
Prediction of left ventricular thrombus after myocardial infarction: a cardiac magnetic resonance-based prospective registry
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.
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
Documentos
- No hay 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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Cita
Bertolin C,Marcos V,Merenciano H,Perez N,Pérez Del Villar C,Gavara J,Lopez MP,Monmeneu JV,Herrera C,Domenech B,López FJ,Rios C,De Dios E,Moratal D,Ortiz JT,Bayes A,Rodríguez JF,Nuñez J,Sánchez PL,Sanchis J,Bodi V. Prediction of left ventricular thrombus after myocardial infarction: a cardiac magnetic resonance-based prospective registry. Eur. J. Intern. Med. 2025. 131. p. 104-112. IF:6,100. (1).
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.
