Dissolution of an apical thrombus by apixaban in a patient with old anteroseptal myocardial infarction.
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ABSTRACT:
SUBMITTER: Yanıkoglu A
PROVIDER: S-EPMC5336870 | biostudies-literature | 2015 Aug
REPOSITORIES: biostudies-literature
Publications
Dissolution of an apical thrombus by apixaban in a patient with old anteroseptal myocardial infarction.
Yanıkoğlu Atakan A Altıntaş Mehmet Sait MS Ekinözü İsmail İ
Anatolian journal of cardiology 20150801 8
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Project description:Cases with thrombi in multiple cardiac chambers are rare. We report an extremely rare case in which thrombi were formed in all four cardiac chambers at the same time. A 55-year-old man presented with biventricular failure and liver dysfunction. A 12-lead ECG and an echocardiogram revealed an old anteroseptal myocardial infarction with aneurysm formation and atrial flutter. A transesophageal echocardiogram and a CT of the chest revealed thrombi in the right and left atrial appendage, right ventricular apex and left ventricular aneurysm. Pulmonary emboli were also identified. Stasis of the blood due to ventricular dysfunction and atrial flutter was considered to be responsible. The patient died of multiorgan failure due to circulatory failure.
| S-EPMC4244429 | biostudies-literature
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| S-EPMC3370091 | biostudies-literature
Project description:We describe a man with cardiac tamponade after anterior myocardial infarction (MI) with a mass on echocardiography, complicated by a S. Milleri purulent pericarditis. This case is an example of how 2 cardiac conditions can interfere with the diagnosis and management of each individual disorder, resulting in an extremely complex disease course. (Level of Difficulty: Beginner.) Central Illustration
| S-EPMC9730162 | biostudies-literature
Project description:BackgroundDirect oral anticoagulants are frequently used to treat post-myocardial infarction (MI) left ventricular thrombus (LVT). This study was conducted to evaluate the efficacy and safety of use of apixaban, compared to the standard warfarin therapy, in post-MI LVT.MethodsThis open-label, randomized controlled trial included patients with post-acute or recent anterior wall MI with transthoracic echocardiography-confirmed LVT. Patients were randomized to receive either apixaban 5 mg twice daily or warfarin to achieve an international normalized ratio of 2-3, in addition to dual antiplatelet therapy. The primary endpoint was LVT resolution at 3 months, with a noninferiority margin of 95% for apixaban compared to warfarin. The secondary endpoint was major adverse cardiovascular events (MACE) or any relevant bleeding according to the Bleeding Academic Research Consortium (BARC) classification.ResultsFifty patients were enrolled from 3 centres. The use of dual or single antiplatelet agents was similar in the 2 groups. The number of 1-, 3-, and 6-month LVT resolutions were 10 (40.0%), 19 (76.0%), and 23 (92.0%) in the apixaban group, and 14 (56%), 20 (80.0%), and 24 (96.0%) in the warfarin group, respectively, without significant differences (P < 0.036 for noninferiority at 3 months). Patients taking warfarin required longer hospital stays and more outpatient visits. Multivariate adjustment analysis revealed left ventricular aneurysm, larger baseline LVT area and lower left ventricular ejection fraction to be independent predictors of LVT persistence at 3 months. No MACE occurred in either group; 1 BARC-2 bleeding event occurred with warfarin.ConclusionsApixaban was not inferior to warfarin in the resolution of post-MI LVT.
| S-EPMC10066447 | biostudies-literature
Project description:An elderly man with a history of coronary artery disease presented with sudden-onset palpitations. The electrocardiogram showed wide complex tachycardia with left bundle branch morphology which terminated spontaneously. Subsequent ECGs confirmed the diagnosis as atrial fibrillation with aberrant conduction because of a diseased left bundle.
| S-EPMC7733571 | biostudies-literature
Project description: Not available
| S-EPMC9970847 | biostudies-literature
Project description:BackgroundIn-hospital left ventricular (LV) thrombus following acute ST-elevation myocardial infarction (STEMI) has not been evaluated on a national scale and was the focus of this investigation.MethodsWe used the 2003 to 2013 Nationwide Inpatient Sample database to identify adults ≥18 years old with a principal diagnosis code of ST-elevation myocardial infarction. Patients were divided into two groups defined by the presence or absence of LV thrombus. Clinical characteristics and in-hospital outcomes were studied using relevant statistics. Multiple linear and logistic regression models were conducted to identify factors associated with LV thrombus.ResultsOf 1,035,888 STEMI patients hospitalized in the U. S from 2003 to 2013, 1982 (0.2%) developed acute in-hospital LV thrombus. Compared to no LV thrombus, patients with LV thrombus were more likely to have in-hospital complications; acute ischemic and hemorrhagic stroke, acute renal failure, gastrointestinal bleed, cardiogenic shock, in-hospital cardiac arrest and mortality. They also had longer mean length of stay and higher hospital charges. Factors associated with LV thrombus included: anterior/anterolateral STEMI, acute or chronic heart failure with reduced ejection fraction, atrial fibrillation, LV aneurysm, Left heart valvular disease, acute or chronic deep venous thrombosis/pulmonary embolism and alcohol abuse. Patients with LV thrombus were less likely to be female [AOR 0.66, 95% CI (0.51-0.84)].ConclusionThe identification of factors associated with early development of LV thrombus following STEMI, will help direct resources for specific high-risk group and prompt cost-effective therapies. Gender variability in LV thrombus development warrants further investigations.
| S-EPMC6891157 | biostudies-literature
Project description:Left ventricular (LV) thrombus formation is a frequent complication in patients with acute anterior myocardial infarction (MI). Its incidence is lower with inferior wall MI. Risk factors for the development of LV thrombus are consistently irrespective of infarct treatment and include large infarct size, severe apical akinesia or dyskinesia LV aneurysm, and anterior MI.
| S-EPMC5353410 | biostudies-literature
Project description:BackgroundCardiovascular diseases (CVD) are among leading causes of death worldwide and amongst CVD, coronary artery disease (CAD) accounts for almost half of all cardiovascular deaths as the most common cause of death in the developed world. Vitamin D and the vitamin D-binding protein (VDBP) have been studied as possible CAD pathogenesis factors but literature data provide opposing evidence on their role in CAD. Herein we aimed to present novel evidence on the association of two VDBP polymorphisms (rs4588) and (rs7041) with CAD in patients after acute myocardial infarction and study possible correlations of these polymorphisms with 25-hydroxyvitamin D [25(OH)D] serum levels.MethodsThe cross-section genotyping study included 155 subjects with CAD upon acute myocardial infarct and 104 control subjects. All patients and control group were Caucasians of European descent. VDBP polymorphisms (rs4588) and (rs7041) were studied by use of RT-PCR. Liquid chromatography, tandem mass spectrometry (LC-MS/MS) method was used for measurement of vitamin D in the serum.ResultsAssociation of the VDBP (rs4588) T/T genotype with CAD patients after acute MI and correlation of VDBP (rs4588) genotype G/G with higher levels of total vitamin D were found. No correlation of 25(OH)D serum levels with CAD were established but the multivariate logistic regression modelling enabled association of total vitamin D level and VDBP (rs4588) T/T genotype with CAD and anteroseptal myocardial infarction (ASMI) CAD occurrence.ConclusionsObtained data speak in favor to the VDBP (rs4588) T/T genotype as a susceptibility factor for anteroseptal myocardial infarction where the same genotype showed to be generally more prevalent in smokers.
| S-EPMC6736812 | biostudies-literature
Project description:Background The previous large-scale randomized controlled trial showed that routine thrombus aspiration (TA) during percutaneous coronary intervention (PCI) was associated with an increased risk of stroke. However, real-world clinical evidence is still limited. Methods and Results We investigated the association between manual TA and stroke risk during primary PCI in the OACIS (Osaka Acute Coronary Insufficiency Study) database (N=12 093). The OACIS is a prospective, multicenter registry of myocardial infarction. The primary end point of the present study is stroke at 7 days. A total of 9147 patients who underwent primary PCI within 24 hours of hospitalization were finally analyzed (TA group, n=4448, versus non-TA group, n=4699 patients). TA was independently associated with risk of stroke at 7 days (odds ratio [OR], 1.92 [95% CI, 1.19‒3.12]; P=0.008) in the simple logistic regression model, while the multilevel random effects logistic regression model with hospital treated as a random effect showed that manual TA was not associated with incremental risk of stroke at 7 days (OR, 0.91 [95% CI, 0.71‒1.16]; P=0.435). The 7-day stroke risk of manual TA was significantly heterogeneous in different institutions (P for interaction=0.007). Conclusions Manual TA during primary PCI for patients with acute myocardial infarction was independently associated with the overall increased risk of periprocedural stroke. However, this result was substantially skewed because of institution specific risk variation, suggesting that the periprocedural stroke may be preventable by prudent PCI procedure or appropriate periprocedural management. Registration URL: https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000005464. Unique identifier: UMIN000004575.
| S-EPMC8751963 | biostudies-literature