Peak C-reactive protein concentration correlates with left ventricular thrombus formation diagnosed by contrast echocardiographic left ventricular opacification in patients with a first anterior acute myocardial infarction.
BACKGROUND
Wall motion abnormality in the apical legion of the left ventricle (LV) with stagnant flow alone is not sufficient to identify patients at high risk for LV thrombus formation among those with first anterior acute myocardial infarction (AMI). The aim of this study was to identify the determinants of LV thrombus formation using contrast echocardiography.


RESULTS
In 75 patients with first anterior AMI, standard and contrast echocardiography was performed to detect LV thrombus. Although LV thrombus was found in 10 patients (13%) using standard echocardiography, it was found in 15 patients (20%) using contrast echocardiography. Apical stagnant flow was observed in 14 patients (93%) with LV thrombus. In addition, patients with LV thrombus had a higher peak C-reactive protein (CRP) concentration (18.2+/-4.3 vs 7.9+/-5.5 mg/dl, p<0.0001). In multivariate analysis, only peak CRP concentration was identified as an independent predictor of LV thrombus (p=0.02, odds ratio: 1.400, confidence interval: 1.040-1.884). The receiver-operating characteristics (ROC) analysis revealed the best cutoff value of a peak CRP concentration >10.7 mg/dl to identify patients with LV thrombus (sensivity 0.93, specificity 0.75, area under ROC curve 0.91).


CONCLUSIONS
The peak CRP concentration is a useful marker of patients with first anterior AMI who are at high risk for LV thrombus.
Seo
Yoshihiro
Y
Cardiovascular Division, Institute of Clinical Medicine, University of Tsukuba, Tennodai, Tsukuba, Japan. seo@bf6.so-net.ne.jp
Maeda
Hiroshi
H
Ishizu
Tomoko
T
Ishimitsu
Toshiyuki
T
Watanabe
Shigeyuki
S
Aonuma
Kazutaka
K
Yamaguchi
Iwao
I
D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D003328:Coronary Thrombosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004452:Echocardiography / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000000981:diagnostic imaging
D002097:C-Reactive Protein