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Systemic embolism in chronic left ventricular aneurysm: incidence and the role of anticoagulation

A C Lapeyre, P M Steele, F J Kazmier

    Journal of the American College of Cardiology
    |September 1, 1985
    PubMed

    Insights

    Systemic embolism is rare in patients with chronic left ventricular aneurysm. This study found the low incidence does not support routine long-term oral anticoagulation therapy for these patients.

    Area of Science:

    • Cardiology
    • Vascular Medicine
    • Thrombosis Research

    Background:

    • Chronic left ventricular aneurysm (LV aneurysm) poses a risk for systemic embolism, but optimal prevention strategies remain debated.
    • Oral anticoagulation is a potential method for preventing embolic events in high-risk cardiovascular conditions.

    Purpose of the Study:

    • To investigate the incidence of systemic embolism in patients with chronic left ventricular aneurysm.
    • To evaluate the effectiveness of oral anticoagulation in preventing embolic events in this patient population.

    Main Methods:

    • Retrospective analysis of 76 patients with angiographically defined left ventricular aneurysm between 1971 and 1979.
    • Comparison of embolic event incidence in patients on oral anticoagulant therapy versus those not receiving it.
    • Follow-up data analyzed for patient-years and survival rates.

    Main Results:

    • Only one non-anticoagulated patient experienced a clinical embolic event (0.35 per 100 patient-years).
    • Survival rates at 3 and 5 years were 75% and 61%, respectively.
    • The study observed a very low incidence of systemic emboli in patients with chronic LV aneurysm.

    Conclusions:

    • The extremely low incidence of systemic emboli in patients with chronic left ventricular aneurysm, in the absence of other risk factors, does not warrant routine long-term oral anticoagulant therapy.
    • Further research may explore specific patient subgroups who might benefit from anticoagulation.
    • Current findings suggest a re-evaluation of anticoagulation guidelines for this condition.

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