Related Experiment Video
Updated: Jul 24, 2025
Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
Clinical profile and prognosis of elderly patients with left ventricular thrombus after anticoagulation
Qian Zhang1, Zhongfan Zhang1, Haikuo Zheng1
1Department of Cardiology, China-Japan Union Hospital of Jilin University, Jilin Provincial Molecular Biology Research Center for Precision Medicine of Major Cardiovascular Disease, Xiantai Street NO. 126, 130000, Changchun, Jilin, China.
Insights
Elderly patients with left ventricular thrombus (LVT) face a poorer prognosis, experiencing higher rates of major adverse cardiovascular events and mortality compared to younger individuals. Anticoagulant type did not significantly impact outcomes in this vulnerable group.
Area of Science:
- Cardiovascular Medicine
- Geriatric Cardiology
- Thrombosis Research
Background:
- Limited contemporary data exists on the clinical characteristics and prognosis of left ventricular thrombus (LVT) in adults aged 65 and older.
- Older adults represent a vulnerable population with LVT, necessitating a deeper understanding of their specific clinical profiles and long-term outcomes.
Purpose of the Study:
- To characterize elderly patients (≥65 years) diagnosed with left ventricular thrombus (LVT).
- To investigate the long-term prognosis and clinical outcomes of LVT in older adults compared to younger patients.
Main Methods:
- Retrospective, single-center study (January 2017 - December 2022) involving 315 patients with LVT, assessed via transthoracic echocardiography (TEE).
- Patients were stratified into elderly (≥65 years) and younger LVT groups, all receiving anticoagulant treatment.
- Major adverse cardiovascular event (MACE) defined as all-cause mortality, systemic embolism, or cardiovascular rehospitalization; survival analyses utilized Kaplan-Meier and Cox proportional-hazard models.
Main Results:
- The elderly LVT group (n=144) exhibited lower male proportion, reduced creatinine clearance, higher NT-proBNP levels, and a greater history of systemic embolism compared to the younger group (n=171).
- LVT resolution rates were similar between elderly (59.7%) and younger (69.0%) groups (aHR, 0.97; P=0.836).
- Elderly patients with LVT demonstrated significantly higher rates of MACE (aHR, 1.52; P=0.012), systemic embolism (aHR, 2.81; P=0.017), and all-cause mortality (aHR, 2.20; P=0.004) compared to younger patients.
Conclusions:
- Elderly patients with LVT experience a significantly poorer prognosis, characterized by increased MACE and mortality, compared to their younger counterparts.
- The type of anticoagulant therapy (DOACs vs. warfarin) did not yield statistically significant differences in prognosis or LVT resolution among elderly patients.
- Further research into antithrombotic therapies tailored for elderly individuals with LVT is crucial, given global population aging trends.
Background:
Contemporary data regarding the clinical characteristics and prognosis of left ventricular thrombus (LVT) in older adults (aged ≥ 65 years old) are lacking. In this study, we characterized elderly patients with LVT (aged ≥ 65 years old) and investigated the long-term prognosis in this highly vulnerable patient population.
Methods:
This single-center, retrospective study was conducted from January 2017 to December 2022. Patients with a reported LVT were assessed primarily by transthoracic echocardiography (TEE) and classified into two groups: elderly LVT groups and younger LVT groups. All patients were treated with anticoagulant treatment. Major adverse cardiovascular event (MACE) was defined as the composite of all-cause mortality, systemic embolism, and rehospitalization for cardiovascular events. Survival analyses were performed with the Kaplan-Meier method and Cox proportional-hazard model.
Results:
A total of 315 eligible patients were included. Compared to the younger LVT group (n = 171), the elderly LVT group (n = 144) had a lower proportion of males and lower serum creatinine clearance, as well as a higher level of NT-proBNP, and a higher rate of history of systemic embolism. LVT resolution occurred in 59.7% and 69.0% of patients in the elderly LVT group and younger LVT group, respectively, with no significant difference (adjusted HR, 0.97; 95% CI, 0.74-1.28; P = 0.836). Yet, elderly patients with LVT, had higher prevalence rates of MACE (adjusted HR, 1.52; 95% CI, 1.10-2.11; P = 0.012), systemic embolism (adjusted HR, 2.81; 95% CI, 1.20-6.59; P = 0.017) and all-cause mortality (adjusted HR, 2.20; 95% CI, 1.29-3.74; P = 0.004) compared with younger patients with LVT. After adjusting for mortality in the Fine-Gray model, similar results were observed. Additionally, patients treated with different anticoagulation therapies (DOACs vs. warfarin) achieved a similar improvement in prognosis (P > 0.05) or LVT resolution (P > 0.05) in elderly patients with LVT.
Conclusions:
Our results found that elderly patients experiencing LVT have a poor prognosis compared with the younger ones. Clinical prognosis in elderly patients did not significantly differ with the type of anticoagulant used. With aging societies worldwide, further evidence of antithrombotic therapy in elderly individuals with LVT is necessary.
More Related Videos
05:26Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
Related Concept Videos
01:29Venous Thrombosis III: Interprofessional Care
01:29Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care
01:20Venous Thrombosis II: Clinical Manifestations and Diagnostic Studies
01:23Mitral Stenosis II: Clinical features and Diagnostic Tests
01:27Pulmonary Embolism III: Nursing Management
01:30Venous Thrombosis IV: Nursing Management