PMID- 26098589
OWN - NLM
STAT- MEDLINE
DCOM- 20160323
LR  - 20161125
IS  - 1424-3997 (Electronic)
IS  - 0036-7672 (Linking)
VI  - 145
DP  - 2015
TI  - Thrombus formation in the left ventricle after large myocardial infarction - 
      assessment with cardiac magnetic resonance imaging.
PG  - w14122
LID - 10.4414/smw.2015.14122 [doi]
AB  - INTRODUCTION: Left ventricular thrombus (LVT) formation may worsen the 
      post-infarct outcome as a result of thromboembolic events. It also complicates 
      the use of modern antiplatelet regimens, which are not compatible with long-term 
      oral anticoagulation. The knowledge of the incidence of LVT may therefore be of 
      importance to guide antiplatelet and antithrombotic therapy after acute 
      myocardial infarction (AMI). METHODS: In 177 patients with large, mainly anterior 
      AMI, standard cardiac magnetic resonance imaging (CMR) including cine and late 
      gadolinium enhancement (LGE) imaging was performed shortly after AMI as per 
      protocol. CMR images were analysed at an independent core laboratory blinded to 
      the clinical data. Transthoracic echocardiography (TTE) was not mandatory for the 
      trial, but was performed in 64% of the cases following standard of care. In a 
      logistic model, 3 out of 61 parameters were used in a multivariable model to 
      predict LVT. RESULTS: LVT was detected by use of CMR in 6.2% (95% confidence 
      interval [CI] 3.1%-10.8%). LGE sequences were best to detect LVT, which may be 
      missed in cine sequences. We identified body mass index (odds ratio 1.18; p = 
      0.01), baseline platelet count (odds ratio 1.01, p = 0.01) and infarct size as 
      assessed by use of CMR (odds ratio 1.03, p = 0.02) as best predictors for LVT. 
      The agreement between TTE and CMR for the detection of LVT is substantial (kappa 
      = 0.70). DISCUSSION: In the current analysis, the incidence of LVT shortly after 
      AMI is relatively low, even in a patient population at high risk. An optimal 
      modality for LVT detection is LGE-CMR but TTE has an acceptable accuracy when 
      LGE-CMR is not available.
FAU - Surder, Daniel
AU  - Surder D
AD  - Fondazione Cardiocentro Ticino, Lugano, Switzerland, and Department of 
      Cardiology, Cardiovascular Centre, University Hospital Zurich, Switzerland.
FAU - Gisler, Valentin
AU  - Gisler V
AD  - Department of Cardiology, Cardiovascular Centre, University Hospital Zurich, 
      Switzerland.
FAU - Corti, Roberto
AU  - Corti R
AD  - Department of Cardiology, Cardiovascular Centre, University Hospital Zurich, 
      Switzerland, and Heart Clinic Hirslanden Zurich, Switzerland.
FAU - Moccetti, Tiziano
AU  - Moccetti T
AD  - Fondazione Cardiocentro Ticino, Lugano, Switzerland.
FAU - Klersy, Catherine
AU  - Klersy C
AD  - IRCCS Fondazione Policlinico San Matteo, Servizio di Biometria e Statistica, 
      Pavia, Italy.
FAU - Zuber, Michel
AU  - Zuber M
AD  - Department of Cardiology, Cantonal Hospital Lucerne, Switzerland, and Cardiology, 
      St. Anna Clinic Hirslanden Lucerne, Switzerland.
FAU - Windecker, Stephan
AU  - Windecker S
AD  - Department of Cardiology, Bern University Hospital, Switzerland.
FAU - Moschovitis, Aris
AU  - Moschovitis A
AD  - Department of Cardiology, Bern University Hospital, Switzerland.
FAU - Kozerke, Sebastian
AU  - Kozerke S
AD  - Institute for Biomedical Engineering, University and ETH Zurich, Switzerland.
FAU - Luscher, Thomas Felix
AU  - Luscher TF
AD  - Department of Cardiology, Cardiovascular Centre, University Hospital Zurich, 
      Switzerland.
FAU - Erne, Paul
AU  - Erne P
AD  - Department of Cardiology, Cantonal Hospital Lucerne, Switzerland, and Heart 
      Clinic Hirslanden Zurich, Switzerland.
FAU - Manka, Robert
AU  - Manka R
AD  - Department of Cardiology, Cardiovascular Centre, University Hospital Zurich, 
      Switzerland, and Institute for Biomedical Engineering, University and ETH Zurich, 
      Switzerland.
LA  - eng
SI  - ClinicalTrials.gov/NCT00355186
PT  - Journal Article
DEP - 20150622
PL  - Switzerland
TA  - Swiss Med Wkly
JT  - Swiss medical weekly
JID - 100970884
RN  - 0 (Anticoagulants)
SB  - IM
CIN - Swiss Med Wkly. 2015;145:w14158. PMID: 26099039
MH  - Aged
MH  - Anticoagulants/therapeutic use
MH  - Body Mass Index
MH  - Echocardiography
MH  - Female
MH  - Heart Ventricles/*diagnostic imaging
MH  - Humans
MH  - Magnetic Resonance Imaging
MH  - Male
MH  - Myocardial Infarction/*complications
MH  - Platelet Count
MH  - Radiography
MH  - Thrombosis/*diagnostic imaging/drug therapy/*etiology
EDAT- 2015/06/23 06:00
MHDA- 2016/03/24 06:00
CRDT- 2015/06/23 06:00
PHST- 2015/06/23 06:00 [entrez]
PHST- 2015/06/23 06:00 [pubmed]
PHST- 2016/03/24 06:00 [medline]
AID - smw-14122 [pii]
AID - 10.4414/smw.2015.14122 [doi]
PST - epublish
SO  - Swiss Med Wkly. 2015 Jun 22;145:w14122. doi: 10.4414/smw.2015.14122. eCollection 
      2015.