Predictors of left ventricular thrombus formation in patients with anterior myocardial infarction: role of activated protein C resistance.
BACKGROUND
Left ventricular mural thrombus formation is a well-recognised consequence of acute anterior myocardial infarction. The vast majority of left ventricular thromboses occur in patients with anterior myocardial infarction and depressed left ventricular function.


OBJECTIVE
To evaluate the factors predicting left ventricular thrombus formation in patients similar for left ventricular function and left ventricular score indexes.


METHODS
We evaluated 45 consecutive patients who met the inclusion criteria of anterior myocardial infarction resulting in apical, anterior or septal asynergy (akinesia, dyskinesia), without non-Q-wave myocardial infarction, dilated cardiomyopathy, or renal or hepatic dysfunction. Patients were divided into two groups: group I with, and group II without, left ventricular mural thrombus. The groups were compared for clinical, echocardiographic and hematologic parameters (activated protein C resistance (APC-R), protein S and antithrombin III).


RESULTS
Smoking and ACP-R were significantly greater in group I than in group II (P < 0.05 and P < 0.005 respectively). Multivariate regression analysis showed that APC-R was an independent risk factor for left ventricular thrombus formation in the patient group selected. Antithrombin III and protein S concentrations were not statistically different between two groups. All other clinical and echocardiographic characteristics of the patients were similar in both groups.


CONCLUSIONS
APC-R is an independent risk factor for left ventricular thrombosis in patients with anterior myocardial infarction resulting in septal or anterior and apical akinesia or dyskinesia.
Yetkin
E
E
Department of Cardiology, Türkiye Yüksek Ihtisas Hospital, Ankara, Turkey. eryetkin@turnet.net.tr
Erbay
A R
AR
Ayaz
S
S
Ileri
M
M
Yanik
A
A
Yetkin
G
G
Cehreli
S
S
Göksel
S
S
D020016:Activated Protein C Resistance / Q000150:complications*; D000990:Antithrombin III / Q000378:metabolism; D003328:Coronary Thrombosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications*; D011379:Prognosis; D017293:Protein S / Q000378:metabolism; D012044:Regression Analysis; D012307:Risk Factors
D017293:Protein S; D000990:Antithrombin III