Preventing Left Ventricular Thrombus Formation

Cavender, Matthew A.; Eubanks, Grayson

doi:10.1016/j.jcin.2022.02.024

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…In addition to other limitations of the trial (eg, single center, open label), there was a high rate of patient dropout (16.5%), and >75% of patients had an LVEF>45%. 51,52 Although a practice of routine prophylactic anticoagulation in all patients does not appear to be supported by data, consideration of the pros and cons of prophylactic anticoagulant therapy to prevent LV thrombus in this setting on a patient-by-patient basis seems prudent. If prophylactic anticoagulation is initiated after MI, we suggest a 1-to 3-month duration because the risk of LV thrombus formation is highest within the first month after MI before declining.…”

Section: Clinical Statements and Guidelinesmentioning

confidence: 99%

See 1 more Smart Citation

Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association

Levine¹,

McEvoy²,

Fang³

et al. 2022

Circulation

112

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Despite the many advances in cardiovascular medicine, decisions concerning the diagnosis, prevention, and treatment of left ventricular (LV) thrombus often remain challenging. There are only limited organizational guideline recommendations with regard to LV thrombus. Furthermore, management issues in current practice are increasingly complex, including concerns about adding oral anticoagulant therapy to dual antiplatelet therapy, the availability of direct oral anticoagulants as a potential alternative option to traditional vitamin K antagonists, and the use of diagnostic modalities such as cardiac magnetic resonance imaging, which has greater sensitivity for LV thrombus detection than echocardiography. Therefore, this American Heart Association scientific statement was commissioned with the goals of addressing 8 key clinical management questions related to LV thrombus, including the prevention and treatment after myocardial infarction, prevention and treatment in dilated cardiomyopathy, management of mural (laminated) thrombus, imaging of LV thrombus, direct oral anticoagulants as an alternative to warfarin, treatments other than oral anticoagulants for LV thrombus (eg, dual antiplatelet therapy, fibrinolysis, surgical excision), and the approach to persistent LV thrombus despite anticoagulation therapy. Practical management suggestions in the form of text, tables, and flow diagrams based on careful and critical review of actual study data as formulated by this multidisciplinary writing committee are given.

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Section: Clinical Statements and Guidelinesmentioning

confidence: 99%

“…In addition to other limitations of the trial (eg, single center, open label), there was a high rate of patient dropout (16.5%), and >75% of patients had an LVEF>45%. 51,52…”

Section: Prevention Of LV Thrombus After Acute Mimentioning

confidence: 99%

Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association

Levine¹,

McEvoy²,

Fang³

et al. 2022

Circulation

112

View full text Add to dashboard Cite

show abstract

Prevention of Left Ventricle Thrombus Formation

Toutouzas¹,

Drakopoulou²,

Oikonomou³

et al. 2022

JACC: Cardiovascular Interventions

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Clinical characteristics and prognostic importance of anticoagulant use in ischemic left ventricular aneurysm: a retrospective cohort study

Chen,

Wang,

Katsouras

et al. 2024

Nat Commun

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There is insufficient data on systemic embolic events (SSEs) in patients with ischemic left ventricular aneurysm (LVA) concerning the impact of anticoagulation therapy. In this retrospective cohort study with 1043 patients with ischemic LVA, SSEs occurred in 7.2% over 2.4 years. After adjusting for relevant factors, the use of anticoagulants was independently associated with a lower incidence of SSE (3.1% vs. 9.0%, P < 0.001; subdistribution hazard ratios (SHR) 0.21, 95% confidence intervals (CI) 0.10-0.44, P < 0.001), with no significant difference in net adverse clinical events (NACEs) (10.6% vs. 13.3%, P = 0.225). Specifically, anticoagulation in patients with apical segment akinesis significantly reduced SSEs (3.9% vs. 13.6%, P = 0.002) and NACE rates (7.8% vs. 19.4%, P = 0.002). Major bleeding rates did not significantly differ between groups (5.6% vs. 3.5%, P = 0.111). These findings highlight the SSE risk in ischemic LVA and suggest potential benefits of anticoagulation, particularly in those with apical segment akinesis. These findings need to be validated in independent datasets.

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Preventing Left Ventricular Thrombus Formation

Cited by 3 publications

References 15 publications

Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association

Management of Patients at Risk for and With Left Ventricular Thrombus: A Scientific Statement From the American Heart Association

Prevention of Left Ventricle Thrombus Formation

Clinical characteristics and prognostic importance of anticoagulant use in ischemic left ventricular aneurysm: a retrospective cohort study

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