Relative Factors Of Left Ventricular Thrombus In Patients With Acute ST-segment Elevation Myocardial Infarction

Background Left ventricular thrombus(LVT)is one of the common serious complications in the early stage of acute myocardial infarction,which can significantly increase the risk of systemic embolism in patients with acute myocardial infarction(AMI).Compared with non-ST-segment elevation myocardial infarction(NSTEMI),patients with ST-segment elevation myocardial infarction(STEMI)are more likely to develop LVT.In recent years,with the rise of percutaneous coronary intervention(PCI)and the gradual improvement of antiplatelet,anticoagulation and other drug treatments,the incidence of LVT has gradually decreased,but it is still a common complication after myocardial infarction One of the symptoms,its fatality rate and disability rate are still high.At present,the research on LVT is limited,and the risk factors are not clear.The purpose of this study is to investigate the influencing factors of left ventricular mural thrombosis in patients with acute ST-segment elevation myocardial infarction.METHODS A total of 151 patients with STEMI in Ma’anshan People’s Hospital from January 2015 to December 2019 were enrolled.They were divided into LVT group(31cases)and non-LVT group(120 cases).Clinical characteristics in the two groups were observed.RESULTS There was no significant difference in general clinical data between the two groups(P>0.05),including age,gender,hypertension,diabetes and hyperlipidemia,smoking and drinking history.There was statistical difference in the duration of sympton onset to admission between the two groups(P<0.05).Patients with LVT had higher rate of anterior myocardial infarction(P<0.001),lower rate of primary PCI(P<0.001),higher rate of LAD lesion(P<0.05).The fibrinogen was higher(P<0.05),the left ventricular ejection fraction(LVEF)was lower and the left ventricular internal dimension in diastole(LVIDd)was larger than that of the non-LVT group.More patients in LVT group had ventricular aneurysm(P<0.001).There was no significant difference in the c Tn I peak,CK-MB peak,mean platelet volume(MPV),platelet-to-lymphocyte ratio(PLR),and neutrophil-to-lymphocyte ratio(NLR)between the two groups(P>0.05).The PPCI(OR=0.23,95%CI:0.073-0.723),LVEF(OR=0.892,95%CI:0.819-0.973)and ventricular aneurysm formation(OR=29.64,95%CI:2.894-303.547)were independent factors influencing LVT.CONCLUSION The duration of sympton onset to admission,anterior myocardial infarction,primary PCI,LAD lesion,fibrinogen,LVEF,LVIDd,and ventricular aneurysm formation are relative factors.