Predictors of left ventricular thrombus formation in patients with anterior myocardial infarction: role of activated protein C resistance

BACKGROUNDLeft ventricular mural thrombus formation is a well-recognised consequence of acute anterior myocardial infarction. The vast majority of left ventricular thromboses occur in patients with anterior myocardial infarction and depressed left ventricular function. OBJECTIVETo evaluate the factors predicting left ventricular thrombus formation in patients similiar for left ventricular function and left ventricular score indexes. METHODSWe evaluated 45 consecutive patients who met the inclusion criteria of anterior myocardial infarction resulting in apical, anterior or septal asynergy (akinesia, dyskinesia), without non-Q-wave myocardial infarction, dilated cardiomyopathy, or renal or hepatic dysfunction. Patients were divided into two groupsgroup I with, and group II without, left ventricular mural thrombus. The groups were compared for clinical, echocardiographic and hematologic parameters (activated protein C resistance (APC-R), protein S and antithrombin III). RESULTSSmoking and ACP-R were significantly greater in group I than in group II (P