Association Between Gensini Score and Left Ventricular Thrombus in Patients With Acute ST-Segment Elevation...

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Imaging

Background:

• Left ventricular thrombus (LVT) is a significant complication following acute ST-segment elevation myocardial infarction (STEMI).
• Early identification of patients at high risk for LVT remains a clinical challenge.
• The Gensini score, derived from coronary angiography, may provide early prognostic insights into LVT development.

Purpose of the Study:

• To investigate the association between the Gensini score and the formation of left ventricular thrombus (LVT) in patients with STEMI.
• To evaluate the utility of the Gensini score for early risk stratification of LVT post-STEMI.

Main Methods:

• A retrospective cohort study involving 144 patients with first STEMI treated with primary percutaneous coronary intervention (PCI).
• Patients were categorized into LVT (n=36) and non-LVT (n=108) groups based on echocardiography.
• Clinical, laboratory, echocardiographic, and angiographic data were analyzed, including calculation of the Gensini score. Multivariable logistic regression and ROC analyses were performed.

Main Results:

• Patients with LVT exhibited a significantly higher median Gensini score (101.0 vs. 46.0, p < 0.001).
• Independent predictors of LVT included higher Gensini score (aOR 1.47), elevated BNP, reduced LVEF, and left ventricular aneurysm.
• Receiver operating characteristic (ROC) analysis indicated an optimal Gensini score cut-off of 72.5 (AUC 0.785) for LVT risk identification.

Conclusions:

• The angiographic Gensini score is an independent predictor of LVT formation after STEMI.
• The Gensini score, readily available post-PCI, improves early risk stratification for LVT.
• Utilizing the Gensini score can guide intensified surveillance and preventive strategies for high-risk STEMI patients.