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RISK OF LEFT VENTRICULAR THROMBUS AFTER STEMI IN THE PRIMARY PCI ERA: A SYSTEMATIC REVIEW AND META-ANALYSIS
489 JACC April 5, 2016 Volume 67, Issue 13
Acute Coronary Syndromes RISK OF LEFT VENTRICULAR THROMBUS AFTER STEMI IN THE PRIMARY PCI ERA: A SYSTEMATIC REVIEW AND META-ANALYSIS Poster Contributions Poster Area, South Hall A1 Saturday, April 02, 2016, 10:00 a.m.-10:45 a.m. Session Title: Predicting Outcomes in Acute Coronary Syndromes Abstract Category: 14. Acute Coronary Syndromes: Clinical Presentation Number: 1100-017 Authors: Austin Robinson, Amit Jain, Mark Gentry, Robert McNamara, Yale School of Medicine, New Haven, CT, USA
Background: Left ventricular thrombus (LVT) is an important complication of myocardial infarction (MI). However, the published rates of LVT since the advent of primary percutaneous coronary intervention (pPCI) are inconsistent, ranging from under 2% to over 34%. In order to better estimate this prevalence, we performed a systematic review and meta-analysis of LVT in patients treated with pPCI for ST segment elevation MI (STEMI). Methods: We searched Ovid MEDLINE and Ovid Embase for English language studies from 1990 to February 2015 documenting echocardiographically diagnosed LVT after STEMI treated with pPCI. Demographic and clinical information was extracted. Primary outcome was rate of LVT on echocardiography obtained within 4 weeks of STEMI. Summary statistic and confidence intervals (CI) were obtained using a random effects model.
Results: From an initial yield of 1144 studies, inclusion criteria were met by 19 studies, including 10,076 patients across 27 centers in 9 countries. Eight studies provided rates of LVT for all STEMI, 5 of which reported rates in the subset of anterior STEMI. Eleven additional studies enrolled only patients with anterior STEMI. Rate of LVT after all STEMI was 2.7% (95% CI 1.9%-3.5%; I2 = 16.4) and 9.1% (95% CI 6.6%-11.6%; I2 = 42.1) after anterior STEMI (see figure). Conclusions: LVT remains a relatively frequent complication of STEMI after pPCI, particularly in anterior STEMI. Adequate assessment and treatment remain critical.
Acute Coronary Syndromes RISK OF LEFT VENTRICULAR THROMBUS AFTER STEMI IN THE PRIMARY PCI ERA: A SYSTEMATIC REVIEW AND META-ANALYSIS Poster Contributions Poster Area, South Hall A1 Saturday, April 02, 2016, 10:00 a.m.-10:45 a.m. Session Title: Predicting Outcomes in Acute Coronary Syndromes Abstract Category: 14. Acute Coronary Syndromes: Clinical Presentation Number: 1100-017 Authors: Austin Robinson, Amit Jain, Mark Gentry, Robert McNamara, Yale School of Medicine, New Haven, CT, USA
Background: Left ventricular thrombus (LVT) is an important complication of myocardial infarction (MI). However, the published rates of LVT since the advent of primary percutaneous coronary intervention (pPCI) are inconsistent, ranging from under 2% to over 34%. In order to better estimate this prevalence, we performed a systematic review and meta-analysis of LVT in patients treated with pPCI for ST segment elevation MI (STEMI). Methods: We searched Ovid MEDLINE and Ovid Embase for English language studies from 1990 to February 2015 documenting echocardiographically diagnosed LVT after STEMI treated with pPCI. Demographic and clinical information was extracted. Primary outcome was rate of LVT on echocardiography obtained within 4 weeks of STEMI. Summary statistic and confidence intervals (CI) were obtained using a random effects model.
Results: From an initial yield of 1144 studies, inclusion criteria were met by 19 studies, including 10,076 patients across 27 centers in 9 countries. Eight studies provided rates of LVT for all STEMI, 5 of which reported rates in the subset of anterior STEMI. Eleven additional studies enrolled only patients with anterior STEMI. Rate of LVT after all STEMI was 2.7% (95% CI 1.9%-3.5%; I2 = 16.4) and 9.1% (95% CI 6.6%-11.6%; I2 = 42.1) after anterior STEMI (see figure). Conclusions: LVT remains a relatively frequent complication of STEMI after pPCI, particularly in anterior STEMI. Adequate assessment and treatment remain critical.