Frequency of Left Ventricular Thrombus After Anterior Wall ST Segment Elevation Myocardial Infarction

Abstract

Background: Left ventricular thrombus (LVT) is a known complication of anterior wall ST segment elevation myocardial infarction (STEMI), associated with increased risk of thromboembolic events. Despite advances in reperfusion therapy, data on its frequency in the local population remain limited, calling for region-specific evidence to guide clinical practice. Objective: To decide the frequency of left ventricular thrombus formation in patients presenting with anterior wall STEMI and evaluate its association with baseline clinical variables and reperfusion strategies. Methods: This was a prospective observational study conducted at the Punjab Institute of Cardiology, Lahore, from September 2, 2024, to February 3, 2025. A total of 100 patients (n = 100), aged 30–80 years, presenting within 12 hours of anterior wall STEMI were enrolled. Patients with hypercoagulable states, cardiopulmonary arrest, or end-stage liver/renal disease were excluded. LVT was assessed using transthoracic echocardiography on the fourth day of admission. Data on demographics, comorbidities, and treatment modality (thrombolysis vs. primary PCI) were collected. Data was analyzed using SPSS v27.0, applying descriptive and inferential statistics (chi-square test, p < 0.05). Results: LVT was detected in 7 patients (7.0%). The mean age of LVT-positive patients was 55.4 ± 7.7 years, and the majority were male (90%). LVT was more frequent among patients undergoing thrombolysis (7.9%) than those who received PCI (5.4%), though the difference was statistically insignificant (p = 0.632). No significant associations were found with smoking, diabetes, or BMI. Conclusion: The frequency of LVT in anterior wall STEMI was 7.0%, emphasizing the need for routine echocardiographic screening post-infarction. Early detection and anticoagulation can prevent embolic complications, supporting its integration into local STEMI management protocols.v