Document Detail

Left ventricular thrombi after short-term high-dose anticoagulants in acute myocardial infarction.
MedLine Citation:
PMID:  3665957     Owner:  NLM     Status:  MEDLINE    
To examine the effect of short-term, high-dose anticoagulation on the subsequent occurrence of left ventricular (LV) thrombi after a first anterior wall acute myocardial infarction (AMI), 21 patients received placebo and 21 high-dose anticoagulants during the first 10 days of the acute infarction. They were studied with cross-sectional echocardiography 10 days and 1.3 and 6 months post infarction. At 1 month, 6 of 7 thrombi present in the placebo group at 10 days were still visible. No thrombi were detected at 10 days in the anticoagulation group, but 6 patients had developed a LV thrombus at 1 month. These 12 patients with LV thrombi were subsequently treated with oral warfarin for 2 months, after which all thrombi had disappeared. Warfarin was then discontinued, and a thrombus had recurred in 5 patients after 6 months. Apical akinesis at 10 days was a predictor for thrombus with a sensitivity and specificity of 100% and 72.2%, respectively. Three of the 13 patients with LV thrombi suffered stroke in contrast to none without thrombi (P = 0.025). We conclude that after discontinuation of short-term high-dose anticoagulation therapy in anterior AMI, LV thrombi may develop rapidly and lead to embolic complications, particularly in patients with persisting apical akinesis.
K A Johannessen; J E Nordrehaug; G von der Lippe
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  8     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1987 Sep 
Date Detail:
Created Date:  1987-12-15     Completed Date:  1987-12-15     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  975-80     Citation Subset:  IM    
Medical Department, Diakonissehjemmet Hospital, Bergen, Norway.
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MeSH Terms
Anticoagulants / therapeutic use*
Heart Diseases / etiology*,  prevention & control
Myocardial Infarction / complications*,  drug therapy
Prospective Studies
Random Allocation
Thrombosis / etiology*,  prevention & control
Time Factors
Reg. No./Substance:

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