Anticoagulation in ischemic left ventricular aneurysm

Mayo Clinic Proceedings
Ga Yeon LeeHyeon-Cheol Gwon

Abstract

To evaluate the role of systemic anticoagulation using warfarin in patients with post-myocardial infarction left ventricular (LV) aneurysm formation with or without definite LV thrombus formation. This study included 648 patients with post-myocardial infarction LV aneurysm formation diagnosed retrospectively by 2-dimensional echocardiography from December 1, 1994, to February 29, 2012. Of these 648 patients, 106 patients received warfarin and 542 patients did not. We studied a composite of death, nonfatal myocardial infarction, cerebrovascular accident, and systemic embolization as the primary outcome and a composite of cerebrovascular accident and systemic embolization as the secondary outcome by using propensity score-adjusted multiple Cox proportional hazards regression analysis. In patients with LV aneurysm, LV thrombus was observed in 89 patients (13.7%) and it was associated with a higher incidence of adverse secondary events (hazard ratio [HR], 3.63; 95% CI, 1.12-11.8; P=.03) in unadjusted analysis. However, in adjusted analysis, anticoagulation did not predict either a better or a worse outcome for primary outcomes (HR, 1.05; 95% CI, 0.67-1.64; P=.84) or for secondary outcomes (HR, 1.52; 95% CI, 0.670-3.46; P=.31). The ...Continue Reading

References

Oct 1, 1993·Journal of the American College of Cardiology·P T Vaitkus, E S Barnathan
Dec 19, 2012·Circulation·Patrick T O'GaraUNKNOWN American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines

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Citations

Mar 11, 2015·Mayo Clinic Proceedings·Joseph G MurphyGregory W Barsness
Aug 29, 2019·Korean Circulation Journal·Jin Oh Choi
Jul 2, 2021·International Journal of Cardiology·Gerlinde van der MatenHeleen M den Hertog
Jun 3, 2021·Journal of Cardiovascular Pharmacology·Murti PatelCory R Trankle

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