title: Left ventricular thrombus and subsequent thromboembolism, comparison of anticoagulation, surgical removal, and antiplatelet agents.
abstract: Left ventricular (LV) thrombus is one of the risk factors for systemic thromboembolism. The aims of this study were to compare the long-term clinical outcomes of LV thrombus using current therapeutics, anticoagulation, operative treatment, and antiplatelet agents and to identify independent predictors of systemic thromboembolism.
  
  
  METHODS
  We screened 86,374 patients for intracardiac thrombus in the electronic medical records and imaging databases. Records of 62 patients with LV thrombus, diagnosed between May 2003 to November 2011, were comprehensively reviewed regarding baseline characteristics, imaging data and thrombus outcomes, thromboembolic events and treatment complications by treatment group.
  
  
  RESULTS
  The majority (80.6%) had ischemic etiology. Systemic thromboembolism developed in 18 patients; 8 (45%) were post-treatment thromboembolisms while 10 events occurred before treatment began. No post-treatment thromboembolism occurred in the operative treatment group; in contrast, 7 post-treatment thromboembolisms occurred in anticoagulation group (17%) (Log rank p= 0.175). Independent predictors of post-treatment thromboembolism were dilated cardiomyopathy (HR 61.30, p= 0.001), previous cerebrovascular events (HR 7.06, p= 0.042), female gender (HR 7.11, p= 0.031), and echocardiographic left ventricular end-diastolic diameter (HR 1.15, p= 0.047).
  
  
  CONCLUSIONS
  In this study, the rate of post-treatment thromboembolism was not significantly different among the treatment groups; however, operative treatment tended towards less post-treatment thromboembolism than other treatment groups.
authors.affiliation: Seoul National University Hospital, Seoul, South Korea.
authors.forename: Joo Myung
authors.initials: JM
authors.lastname: Lee
authors.forename: Jin Joo
authors.initials: JJ
authors.lastname: Park
authors.forename: Hee Won
authors.initials: HW
authors.lastname: Jung
authors.forename: Young-Seok
authors.initials: YS
authors.lastname: Cho
authors.forename: Il-Young
authors.initials: IY
authors.lastname: Oh
authors.forename: Chang-Hwan
authors.initials: CH
authors.lastname: Yoon
authors.forename: Jung-Won
authors.initials: JW
authors.lastname: Suh
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Chun
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Choi
authors.forename: Tae-Jin
authors.initials: TJ
authors.lastname: Youn
authors.forename: Cheong
authors.initials: C
authors.lastname: Lim
authors.forename: Goo-Yeong
authors.initials: GY
authors.lastname: Cho
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Chae
authors.forename: Kay-Hyun
authors.initials: KH
authors.lastname: Park
authors.forename: Dong-Ju
authors.initials: DJ
authors.lastname: Choi
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D006352:Heart Ventricles / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008485:Medical Audit; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013923:Thromboembolism / Q000188:drug therapy* / Q000601:surgery*; D013927:Thrombosis / Q000188:drug therapy* / Q000601:surgery*
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors