SESSION TITLE: Signs and Symptoms of Chest Diseases Posters
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM
PURPOSE: LVT formation is a known complication after STEMI. Despite a decline in the PCI era, its incidence has varied from 2.5 - 15% in STEMI and upto 23.5% in anterior wall myocardial infarction (AWMI). The primary aim of our study was to estimate the incidence of LVT in STEMI patients undergoing primary PCI in a tertiary care setting. The secondary aim was to detect differences in left ventricular ejection fraction (LVEF) and symptom onset to balloon times in patients who had LVT versus those who did not.
METHODS: We studied 543 STEMI patients undergoing primary PCI from 2007-2013 at our hospital. Presence of LVT and LVEF were determined by transthoracic echocardiogram (TTE), which was done prior to discharge. Since the data were not normally distributed, we used non parametric methods.
RESULTS: There were 391 (72.01%) males and 152 (27.99%) females. The mean age was 60.1 years. 6 patients had LVT on TTE (1.1%), all of which were AWMI. A total of 211 patients (38.8%) had AWMI. Incidence of LVT in AWMI was 2.84%. Median LVEF was significantly lower in patients with LVT [37.5% (interquartile range (IQR), 22.5-46.25%] compared to patients without LVT [50% (IQR, 40-57.5%)], p =0.034. Although higher in patients with LVT, the median symptom onset to balloon time was not significantly different in patients with LVT [347 minutes, IQR (102.5-15180 minutes)] compared to patients without LVT [155 minutes, IQR (106-8705 minutes)], p =0.245. LVT developed within 24 hours in 5 patients (83.3%). 1 of 6 patients (16.7%) had embolic stroke and died.
CONCLUSIONS: Our study showed lower incidence of LVT compared to other studies in PCI era. All the patients who developed LVT had AWMI. Median LVEF was significantly lower in patients with LVT. Although higher in patients with LVT, median symptom onset to balloon time was not significantly different in patients with or without LVT.
CLINICAL IMPLICATIONS: It is important to watch out for LVT after STEMI especially in AWMI and those with reduced EF as mortality due to embolic complications is high.
DISCLOSURE: The following authors have nothing to disclose: Sundermurthy Yamini, Ashesha Mechineni, Priyank Shah, Sharad Bajaj, Hartaj Virk, Fayez Shamoon, Mahesh Bikkina
No Product/Research Disclosure Information