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Table 1 Characteristics of included studies

From: Incidence and predictors of left ventricular thrombus by cardiovascular magnetic resonance in acute ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: a meta-analysis

Study Patients Clinical characteristics CMR Technique Findings Comments
Delewi 2012 [12] 194 STEMI (123 anterior)
Multicentre
Substudy of an RCT
Age: 56 ± 9 years
Male: 85%
DM: 6%
Smoker: 52%
MI size: 23 ± 12 g
1.5 T
Between 2 and 7 (4 ± 2) days and at 4 months
Cine + LGE imaging 17 (8.8%) early LV thrombus and 12 late LV thrombus
All LV thrombus were in anterior STEMI
8/17 patients with LV thrombus treated with anticoagulation
15/17 LV thrombus resolved by 4 months
Lanzillo 2013 [11] 36 STEMI (19 anterior)
Single centre
Age: 59 ± 10 years
Male: 89%
DM: 22%
Smoker: 69%
MI size: 40 ± 13%
1.5 T
Within 7 days (5.5 ± 1.4 days)
LGE imaging 7 (19%) LV thrombus
All LV thrombus were in anterior STEMI
All resolved by 1 month
Pöss 2015 [10] 738 STEMI (339 anterior)
Multicentre
Substudy of an RCT
Age: 62 (51–71) years
Male: 76%
DM: 20%
Smoker: 47%
MI size: 17 (8–25)%
1.5 T and 3 T
CMR between days 1 to 10, median 3 days
Cine + LGE imaging 26/738 (3.5%) LV thrombus 24/26 (92%) we in anterior STEMI LV thrombus was associated with larger MI size, lower LVEF and increased rate of MACE (Death, re-infarction and new HF)
Weinsaft 2016 [4] 201 STEMI (108 anterior) Age: 56 ± 12 years
Male: 84%
DM: 23%
Smoker: 32%
MI size: 15 (6–23)%
1.5 T
Between 7 and 30 days (28 ± 6 days)
Long inversion time LGE 17/201 (8%) LV thrombus
16/17 of the LV thrombus were in anterior STEMI
LV thrombus was associated with apical LV dysfunction
Bière 2016 [14] 329 STEMI
(183 anterior)
Single centre
Age: 58 ± 11 years
Male: 82%
DM: 12%
Smoker: 43%
MI size: 20 ± 13%
1.5 T and 3 T
Day 6 (4–8) and at 3 months
First pass perfusion 22 (6.7%) early LV thrombus and 9 (2.9%) late LV thrombus
All LV thrombus were in anterior STEMI
FFP improved detection of LV thrombus over cine and LGE images
Cambronero-Cortinas 2017 [13] 574 STEMI patients had the acute CMR only. 392 STEMI (207 anterior) had paired acute and follow-up CMR
Single centre
Age: 58 ± 12 years
Male: 82%
DM: 19%
Smoker: 60%
MI size: 19 (10–30)%
1.5 T
7 ± 2 days and 6 months (those with LV thrombus were rescanned at 1 year (11/13)
LGE imaging 574 with CMR at 1 week (LV thrombus 28–5%)
18 (5%) early LV thrombus and 9 (2%) late LV thrombus
4/18 (24%) still had LV thrombus at 6 months (anterior)
11 with LV thrombus at 6 months – 3/11 (27%) still had LV thrombus at 1 year (3/25–12%)
LVEF< 50% and anterior STEMI independently predicted LV thrombus (c-statistic 0.82)
Patients with anterior infarction and LVEF < 50% are at highest risk of developing LV thrombus (23/115, 20%).
Gellen 2017 [9] 265 anterior STEMI Age: 58 ± 12 years
Male: 85%
DM: 44%
Smoker: 43%
MI size: 31 ± 12%
CMR within 21 days LGE imaging 34/265 (12.8%) with LV thrombus CMR ≤ 5 days: 13/160
CMR > 5 days: 21/105
The highest LV thrombus detection rate was in patients with CMR performed 9 to 12 days after STEMI
Weir 2009 [15] 100 Acute MI (90 STEMI, 10 NSTEMI) with LVEF< 40% Age: 59 ± 12 years
Male: 77%
DM: 0%
Smoker: 55%
MI size: 33 ± 21 ml/m2
CMR at a mean of 4.2 days (range 2–11 days) First-pass perfusion + LGE 15/100 (15%) with LV thrombus
All anterior MI (15/55, 27.3%)
All patients with LV thrombus were formally anticoagulated.
No patients with thromboembolic events at 6 months
Surder 2015 [16] Substudy of SWISS-AMI study
177 anterior STEMI with LVEF< 45%
Age: 57 ± 10 years
Male: 85%
DM: 11%
Smoker: 59%
MI size: 29 ± 12%
CMR at a median of 6 (4–8)days Cine + LGE imaging 11/177 (6.2%) with LV thrombus All patients with LV thrombus were anticoagulated.
Meurin 2015 [17] 100 anterior STEMI with LVEF< 45% Age: 59 ± 12 years
Male: 71%
DM: 20%
Smoker: 43%
LVEF: 33 ± 6%
CMR at a median of 30 days (range 20–40 days) Cine + LGE imaging 26/100 (26%) with LV thrombus All patients with LV thrombus were started on anticoagulation
  1. STEMI ST-segment elevation myocardial infarction, DM diabetes mellitus, MI myocardial infarct, CMR cardiovascular magnetic resonance, RCT randomized controlled trial, LGE late gadolinium enhancement, LV left ventricular, LVEF left ventricular ejection fraction, MACE major adverse cardiovascular event, CCF congestive cardiac failure, FFP first pass perfusion