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Characterisation of patients with acute myocardial infarction complicated by left ventricular thrombus

  • Author Footnotes
    1 Both authors contributed equally to this manuscript
    Aloysius Sheng-Ting Leow
    Footnotes
    1 Both authors contributed equally to this manuscript
    Affiliations
    Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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  • Author Footnotes
    1 Both authors contributed equally to this manuscript
    Ching-Hui Sia
    Correspondence
    Corresponding author.
    Footnotes
    1 Both authors contributed equally to this manuscript
    Affiliations
    Department of Cardiology, National University Heart Centre, Singapore, 1E Kent Ridge Road Level 9 Singapore 119228

    Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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  • Benjamin Yong-Qiang Tan
    Affiliations
    Division of Neurology, Department of Medicine, National University Health System, Singapore
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  • Mark Yan-Yee Chan
    Affiliations
    Department of Cardiology, National University Heart Centre, Singapore, 1E Kent Ridge Road Level 9 Singapore 119228

    Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore

    Cardiovascular Research Institute, National University of Singapore, Singapore
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  • Joshua Ping-Yun Loh
    Affiliations
    Department of Cardiology, National University Heart Centre, Singapore, 1E Kent Ridge Road Level 9 Singapore 119228

    Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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  • Author Footnotes
    1 Both authors contributed equally to this manuscript
Published:January 16, 2020DOI:https://doi.org/10.1016/j.ejim.2020.01.003
      Left ventricular (LV) thrombus is a known complication of acute myocardial infarction (AMI), with a reported incidence ranging from 0.7 to 4.3% in the era of primary percutaneous coronary intervention (PCI) [
      • Garber A.M.
      • Mentz R.J.
      • Al-Khalidi H.R.
      • Shaw L.K.
      • Fiuzat M.
      • O'Connor C.M.
      • Velazquez E.J.
      Clinical predictors and outcomes of patients with left ventricular thrombus following ST-segment elevation myocardial infarction.
      ,
      • Jiang Y.-.X.
      • Jing L.-.D.
      • Jia Y.-.H.
      Clinical characteristics and risk factors of left ventricular thrombus after acute myocardial infarction: a matched case-control study.
      ]. Previous studies have demonstrated that anterior ST segment elevation myocardial infarction (STEMI) and a left ventricular ejection fraction (LVEF) ≤ 40% are significant predictors of LV thrombus development [
      • Solheim S.
      • Seljeflot I.
      • Lunde K.
      • Bjørnerheim R.
      • Aakhus S.
      • Forfang K.
      • Arnesen H.
      Frequency of left ventricular thrombus in patients with anterior wall acute myocardial infarction treated with percutaneous coronary intervention and dual antiplatelet therapy.
      ]. On the other hand, non-STEMI (NSTEMI) represents a distinct pathophysiology and NSTEMI patients often undergo early, as opposed to immediate revascularisation as in STEMI patients [
      • McManus D.D.
      • Gore J.
      • Yarzebski J.
      • Spencer F.
      • Lessard D.
      • Goldberg R.J.
      Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI.
      ]. With the majority of reported clinical series on LV thrombus solely focused on post-STEMI patients [
      • Robinson A.A.
      • Jain A.
      • Gentry M.
      • McNamara R.L.
      Left ventricular thrombi after STEMI in the primary PCI era: a systematic review and meta-analysis.
      ], it is unknown whether NSTEMI patients with LV thrombus have significant differences in terms of clinical characteristics and outcomes. Hence, we aimed to characterise post-AMI patients with concomitant LV thrombus formation and examine the impact of NSTEMI and LVEF on various outcomes in these patients.
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