Abstract
BackgroundThe predictors of left ventricular thrombus (LVT) formation are not well defined in the contemporary era, especially in those patients at high risk. We aimed to evaluate whether the platelet/lymphocyte ratio (PLR) is valuable in the determination of LVT formation in patients with anterior ST-elevation myocardial infarction (STEMI) and left ventricular (LV) dysfunction.MethodsThe LVT group (n = 46) was identified from anterior STEMI patients with LV dysfunction who were treated with primary percutaneous coronary intervention (PCI) from January 2017 to December 2019 at the China-Japan Union Hospital of Jilin University. The no-LVT group (n = 92) were also selected from the same batch of patients and were age- and sex-matched to the patients with LVT. The PLR was determined at admission and was calculated as the ratio of the platelet count to the lymphocyte count using the complete blood count. The presence of LVT was determined by echocardiography.ResultsThe PLR were significantly higher in patients with LVT than in no-LVT group (p = 0.001). In a receiver operator characteristic curve (ROC) analysis, using a cut-off value of 118.07 (AUC 0.673, 95% CI: 0.574–0.771, P = 0.001), the PLR could independently predict the occurrence of LVT. Multivariate analysis showed that an increased PLR (OR = 1.011, 95% CI: 1.004–1.018, P = 0.002), the presence of a left ventricular aneurysm (OR = 46.350, 95% CI: 5.659–379.615, P < 0.001) and increased DTBT (OR = 1.005, 95% CI: 1.001–1.009, P = 0.012) were independent predictors of LVT formation.ConclusionsIn acute anterior STEMI patients with LV dysfunction, an increased PLR and DTBT and the presence of an LV aneurysm were independent predictors of LVT formation. A larger prospective study is warranted to evaluate this result.Trial registrationThis study was registered (May 4, 2019) on Chinese Clinical Trial Registry (ChiCTR-DDD-17011214).
Highlights
The predictors of left ventricular thrombus (LVT) formation are not well defined in the contemporary era, especially in those patients at high risk
A total of 132 patients participated in this retrospectively matched case-control study. They were divided into the LVT group (n = 46) and the no-LVT group (n = 92)
The results demonstrated that both ventricular aneurysm and left ventricular diameter were significantly higher in the LVT group than in the no-LVT group (P < 0.05)
Summary
The predictors of left ventricular thrombus (LVT) formation are not well defined in the contemporary era, especially in those patients at high risk. We aimed to evaluate whether the platelet/lymphocyte ratio (PLR) is valuable in the determination of LVT formation in patients with anterior ST-elevation myocardial infarction (STEMI) and left ventricular (LV) dysfunction. Left ventricular thrombus (LVT), one of the most common complications of acute anterior myocardial infarction, is linked to the potentially devastating outcome of thromboembolism or stroke [1, 2]. A prospective multicenter study showed that the incidence of LVT among patients with LV dysfunction after anterior myocardial infarction was up to 26% [5].
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