Anticoagulant drugs in noncompaction: a mandatory therapy?
BACKGROUND
Noncompaction of left ventricular myocardium is a rare congenital cardiomyopathy resulting from an incomplete myocardial morphogenesis that leads to the persistence of the embryonic myocardium. This condition is characterized by a thin compacted epicardial and an extremely thickened endocardial layer with prominent trabeculations and deep intertrabecular recesses. It is not clear, in noncompaction of myocardium, whether intertrabecular recesses could be responsible for thrombi formation and thromboembolic complications.


METHODS
The prevalence of stroke and echocardiographic finding of thrombus was evaluated in a continuous series of 229 patients (men and women) affected by noncompaction of the left ventricular myocardium, who were included in the SIEC registry. We excluded patients affected by atrial fibrillation.


RESULTS
The mean age of the patients was 49.5 years. Fifty percent of the patients were affected by a ventricular systolic dysfunction. The mean period of follow-up was 7.3 years. Only four patients had a history of ischemic stroke. A large thrombus into the left ventricular chamber was observed in a 1-year-old child affected by Behcet's disease (high risk of thrombi formation).


CONCLUSIONS
Noncompaction of the left ventricular myocardium, by itself, does not seem to be a risk factor for stroke or embolic results, so there is no indication for oral anticoagulant therapy.
Department of Cardiology, University of Palermo, Palermo, Italy. Giovanni.fazio-aaaa@poste.it
Giovanni
G
Fazio
Giovanni
G
Corrado
Elisabetta
E
Zachara
Claudio
C
Rapezzi
Ali K
AK
Sulafa
Loredana
L
Sutera
Claudia
C
Stollberger
Luca
L
Sormani
Joseph
J
Finsterer
Abraham
A
Benatar
Gabriele
G
Di Gesaro
Claudia
C
Visconti
Luciana
L
D'angelo
Giuseppina
G
Novo
Maurizio
M
Mongiovi
Yuksel
Y
Cavusoglu
Magnus
M
Baumhakel
Fabrizio
F
Drago
Giuseppe
G
Indovina
Filippo
F
Ferrara
Scipione
S
Carerj
Salvatore
S
Pipitone
Salvatore
S
Novo
D000284:Administration, Oral; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D009202:Cardiomyopathies / Q000150:complications / Q000151:congenital / Q000188:drug therapy*; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000188:drug therapy*; D006352:Heart Ventricles / Q000002:abnormalities / Q000187:drug effects*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D013997:Time Factors
D000925:Anticoagulants