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In-hospital left ventricular thrombus following ST-elevation myocardial infarction.

Authors
  • Albaeni, Aiham1
  • Chatila, Khaled2
  • Beydoun, Hind A3
  • Beydoun, May A4
  • Morsy, Mohammad2
  • Khalife, Wissam I2
  • 1 Department of Medicine, University of Central Florida, Ocala, FL, United States of America. Electronic address: [email protected] , (United States)
  • 2 Department of Medicine, Division of Cardiology, University of Texas Medical branch, Galveston, TX, United States of America. , (United States)
  • 3 Division of Research Programs, Office of Education Training and Research, Fort Belvoir Community Hospital, Fort Belvoir, VA.
  • 4 Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, United States of America. , (United States)
Type
Published Article
Journal
International journal of cardiology
Publication Date
Jan 15, 2020
Volume
299
Pages
1–6
Identifiers
DOI: 10.1016/j.ijcard.2019.07.070
PMID: 31371119
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In-hospital left ventricular (LV) thrombus following acute ST-elevation myocardial infarction (STEMI) has not been evaluated on a national scale and was the focus of this investigation. We used the 2003 to 2013 Nationwide Inpatient Sample database to identify adults ≥18 years old with a principal diagnosis code of ST-elevation myocardial infarction. Patients were divided into two groups defined by the presence or absence of LV thrombus. Clinical characteristics and in-hospital outcomes were studied using relevant statistics. Multiple linear and logistic regression models were conducted to identify factors associated with LV thrombus. Of 1,035,888 STEMI patients hospitalized in the U. S from 2003 to 2013, 1982 (0.2%) developed acute in-hospital LV thrombus. Compared to no LV thrombus, patients with LV thrombus were more likely to have in-hospital complications; acute ischemic and hemorrhagic stroke, acute renal failure, gastrointestinal bleed, cardiogenic shock, in-hospital cardiac arrest and mortality. They also had longer mean length of stay and higher hospital charges. Factors associated with LV thrombus included: anterior/anterolateral STEMI, acute or chronic heart failure with reduced ejection fraction, atrial fibrillation, LV aneurysm, Left heart valvular disease, acute or chronic deep venous thrombosis/pulmonary embolism and alcohol abuse. Patients with LV thrombus were less likely to be female [AOR 0.66, 95% CI (0.51-0.84)]. The identification of factors associated with early development of LV thrombus following STEMI, will help direct resources for specific high-risk group and prompt cost-effective therapies. Gender variability in LV thrombus development warrants further investigations. Copyright © 2019 Elsevier B.V. All rights reserved.

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