Prevalence and Predictors of Thromboembolic Events in Patients with Left Ventricular Dysfunction and Left Ventricular Thrombus.

IF 1.9 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiology Pub Date : 2024-08-27 DOI:10.1159/000541106

Yoonsun Won, Kyung Eun Ha, Se-Eun Kim, Joonpyo Lee, Chan Joo Lee, Jeonggeun Moon

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引用次数: 0

Abstract

Introduction: Thromboembolic events (TEs) associated with left ventricular (LV) thrombus (LVT) are of clinical concern; however, further investigation into their prevalence and risk predictors is warranted.

Methods: We retrospectively identified 256 patients diagnosed with LVT by echocardiography between 2010 and 2021. The primary outcome was the occurrence of TE, including stroke and arterial thromboembolism. Patients were divided into TE (+) and TE (-) groups for clinical comparison, with a focus on factors related to TE.

Results: The TE event rate was 9% over a median period of 4 ± 3 years. Notably, most TE occurred within 3 months and became scarce after 2 years of follow-up; based on this, LVT chronicity was defined as LVT persistency for ≥2 years. A prior TE history proved to be a positive predictor of TE (hazard ratio [HR]: 5.92, confidence interval [CI]: 1.45-24.18, p = 0.01), while LVT chronicity showed to be a negative predictor (HR: 0.04, CI: 0.01-0.15, p < 0.001). LVT chronicity accurately predicted TE (area under curve of 0.86 [95% CI: 0.80-0.93], cutoff value of 794 days [sensitivity: 69%, specificity: 91%]).

Conclusion: TE associated with LVT occurs in the early period of recognition, and a history of TE is an independent predictor for future TE. Once LVT becomes chronic (≥2 years), TE is rare.

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左心室功能障碍和左心室血栓患者血栓栓塞事件的发生率和预测因素。

背景：与左心室血栓（LVT）相关的血栓栓塞事件（TE）是临床关注的焦点；然而，有必要进一步调查其发生率和风险预测因素：我们对 2010 年至 2021 年间通过超声心动图确诊的 256 例左心室血栓患者进行了回顾性鉴定。主要结果是TE的发生，包括中风和动脉血栓栓塞。患者被分为TE（+）组和TE（-）组进行临床比较，重点关注与TE相关的因素：在4±3年的中位时间内，TE事件发生率为9%。值得注意的是，大多数 TE 发生在 3 个月内，随访 2 年后变得稀少；据此，LVT 慢性化被定义为 LVT 持续≥2 年。事实证明，既往TE史是TE的阳性预测因素（危险比，HR:5.92，置信区间，CI:1.45-24.18，p=0.01），而LVT慢性化则是阴性预测因素（HR:0.04，CI:0.01-0.15，p<0.001）。LVT 慢性化可准确预测 TE（曲线下面积为 0.86 [95% CI：0.80-0.93]，临界值为 794 天[敏感性：69%，特异性：91%]）：结论：与 LVT 相关的 TE 发生在识别的早期阶段，TE 病史是未来 TE 的独立预测因素。一旦 LVT 变成慢性（≥2 年），TE 就很少见了。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiology 医学-心血管系统

CiteScore

3.40

自引率

5.30%

发文量

审稿时长

1.5 months

期刊介绍： ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.