Abstract
BackgroundLeft ventricular thrombus(LVT] formation is a frequent complication in patients with acute anterior myocardial infarction(MI). LVT is associated with increased risk of embolism and higher mortality rates after acute MI. Anticardiolipin antibodies (ACA) are immunoglobulins that react with phospholipid-binding proteins interfering with the prothrombin activator complex. The effects of phospholipids on pathophysiology of cardiovascular thrombotic events are well known. In this study, we aimed to evaluate the importance of clinical and biochemical parameters including anticardiolipin antibodies on left ventricular thrombus formation after acute anterior MI.Methods and ResultsSeventy patients with a first anterior AMI were prospectively and consecutively enrolled. Patients with previous MI, autoimmune disease, collagen vascular disease and arterial or venous thrombosis history were excluded from this study. At the time of hospitalization, key demographic and clinical characteristics were collected including age, gender, ethanol intake and presence of traditional risk factors for atherosclerosis (hypertension, diabetes, smoking, hyperlipidemia, positive family history). Patients were evaluated for echocardiographic data, blood chemistry and ACA. Two-dimensional and Doppler echocardiographic examinations were performed in all patients within the first week and at 14 days after MI. LV thrombus was detected in 30 (42.8%) patients. ACA IgM levels were significantly higher in the patient group with LV thrombus than in the group without thrombus (12.44 ±4.12 vs. 7.69 ± 4.25 mpl, p = 0,01). ACA IgG levels were also found higher in the group with LV thrombus (24.2 ± 7.5 vs.17.98 ± 6.45 gpl, p = 0.02). Multivariate analyses revealed diabetes mellitus, higher WMSI, lower MDT and higher ACA IgM and higher ACA IgG levels as independent predictors of left ventricular thrombus formation.ConclusionsOur data demonstrate that beside the low ejection fraction, lower MDT and higher wall motion score index, modestly elevated ACA IgM and ACA IgG levels are associated with LV thrombus formation in patients with anterior MI.
Highlights
Left ventricular thrombus(LVT) formation is a frequent complication in patients with acute anterior myocardial infarction(MI)
Our data demonstrate that beside the low ejection fraction, lower mitral E wave deceleration time (MDT) and higher wall motion score index, modestly elevated Anticardiolipin antibodies (ACA) IgM and ACA IgG levels are associated with LV thrombus formation in patients with anterior MI
Anticardiolipin antibodies (ACA) are immunoglobulins that react with phospholipid-binding proteins interfering with the prothrombin activator complex
Summary
Left ventricular thrombus(LVT) formation is a frequent complication in patients with acute anterior myocardial infarction(MI). Left ventricular thrombus is associated with increased risk of embolism. The effects of phospholipids on pathophysiology of venous and cardiovascular thrombotic events are well known. There is no detailed study evaluating the effects of ACA IgM and ACA IgG levels on development of left ventricular thrombus formation in patients with acute anterior myocardial infarction. LVT is associated with increased risk of embolism and higher mortality rates after acute MI. The effects of phospholipids on pathophysiology of cardiovascular thrombotic events are well known.
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