Abstract 14209: Natural History of Resolved Left Ventricular Thrombi

Abstract

Introduction: Left ventricular thrombi (LVT) are associated with a significantly increased risk of systemic thromboembolism with its major clinical complications especially cerebrovascular stroke. Several societal guidelines recommend a duration of 3 to 6 months of anticoagulation (AC). However, evidence regarding LVT recurrence after AC discontinuation is lacking. Hypothesis: To determine the clinical characteristics associated with LVT recurrence in patients with resolved LVT after AC discontinuation. Methods: Follow-up data of 52 patients with resolved LVT derived from the Comparative Study of Oral Anticoagulation in Left Ventricular Thrombi (No-LVT Trial) was retrospectively analyzed. Results: 47 patients (90.38%) had no recurrence of LVT while 5 patients (9.61%) had LVT recurrence at a mean follow-up duration of 86.17±20.54 and 81±26.08 days, respectively. There was no statistically significant difference in age, gender, diabetes, hypertension, smoking or etiology of heart failure between the two groups. Baseline and follow-up left ventricular ejection fraction (LVEF) were lower in patients with recurrent LVT (32.4±5.37% and 40.34±4.08% respectively) compared to the no recurrence group (39.36±4.68% and 54.24±5.09% respectively) which was statically significant (p=value of 0.003*, <0.0001* respectively). Conclusions: In patients with resolved LVT, low LVEF was the strongest predictor of LVT recurrence after AC discontinuation. Further research is required to determine clinical characteristics associated with LVT recurrence and indications for extended duration of AC in LVT treatment.