Prevalence of early left ventricular thrombus after primary coronary intervention for acute myocardial infarction

The prevalence of left ventricular (LV) thrombus after acute myocardial inf arction (AMI) has been reported high at 20-60%. Current reperfusion therapi es such as thrombolysis have shown a trend toward reducing the incidence of LV thrombosis. However, the prevalence of LV thrombus after primary percut aneous coronary intervention (PCI) for AMI has not been systematically stud ied. At Massachusetts General Hospital 71 consecutive patients who underwen t primary PCI for acute ST elevation MI were reviewed for the prevalence of LV thrombus evaluated by echocardiography. Echocardiography was performed within 5 days of infarction. PCI was successful in all patients. The time d elay from symptom onset to intervention was 191 minutes. Thrombolysis in My ocardiol Infarction (TIMI) grade 3 flow was achieved in more than 80% of ca ses. Only 3 patients (4%) had echocardiographic evidence of LV thrombus. Al l 3 patients had anterior infarctions. The incidence among patients with an terior MI was 10% (3 of 30 patients). The prevalence of LV thrombus in pati ents treated with primary PCI for AMI is low (4%).