[The incidence and clinical implications of left ventricular thrombosis in 769 patients with acute myocardial infarct treated with antithrombotics and fibrinolytics].
Seven hundred sixty-nine patients (pts) admitted to the Coronary Care Unit (CCU) between January 1987 and January 1990 suffering from first acute myocardial infarction (AMI) were studied. The presence of left ventricular thrombosis (LVT) was evaluated by two-dimensional echocardiography (2D-echo). The relation of LVT to site, size and intra-CCU clinical outcome of AMI, in terms of systemic embolic events, Killip class and mortality, was also assessed. AMI was transmural in 707 pts (92%), anterior in 446 pts (58%) and inferior in 261 pts (34%), non-Q in 62 pts (8%). Two hundred sixty-one pts (34%) were treated with IV thrombolytic therapy followed by IV heparin 1000 IU/h over 12 hrs and then calcium heparin (CH) 12500 IU s.c. bid; 508 pts (66%) were given only antithrombotic therapy (CH 12500 IU s.c. bid). 2D-Echo was performed within 48 hours and on day 5-7 from the onset of AMI. In 41 pts (5.3%) LVT was observed: 39 had anterior AMI (8.7% of all anterior AMI pts), one had inferior AMI (0.4% of all inferior AMI pts), and one had non-Q AMI (1.6% of all non-Q AMI pts) [p less than 0.001 for anterior AMI vs inferior and non-Q AMI]. Pts with LVT had a greater infarct size (number of akinetic plus dyskinetic segments/total number of segments x 100) compared to pts without LVT (32.3 +/- 12.6% vs 16.4 +/- 5.7%, p less than 0.001). In pts treated with thrombolytic therapy, LVT incidence was not significantly different from that of pts treated with antithrombotic therapy (4.2% vs 5.9%) alone.(ABSTRACT TRUNCATED AT 250 WORDS)
Boccardi
L
L
Servizio di Poligrafia e Cardiodiagnostica Incruenta, Ospedale S. Camillo, Roma.
Natale
E
E
Minardi
G
G
Tubaro
M
M
Pucci
E
E
Ricci
R
R
Di Segni
M
M
Di Marcotullio
G
G
Malinconico
U
U
Giovannini
E
E
D016009:Chi-Square Distribution; D016001:Confidence Intervals; D004359:Drug Therapy, Combination; D004452:Echocardiography; D006352:Heart Ventricles; D006493:Heparin / Q000008:administration & dosage*; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D009203:Myocardial Infarction / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology; D013300:Streptokinase / Q000008:administration & dosage*; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage*
D006493:Heparin; D013300:Streptokinase; D014568:Urokinase-Type Plasminogen Activator
Incidenza e implicazioni cliniche della trombosi ventricolare sinistra in una casistica di 769 pazienti con infarto miocardico acuto trattati con antitrombotici e fibrinolitici.