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

Yang You1, Hongliang Zhao1, Haijiao Jin1

  • 1Department of Cardiology, The First Hospital of Hebei Medical University, 050000 Shijiazhuang, Hebei, China.

Reviews in Cardiovascular Medicine
|July 8, 2026
PubMed

Insights

The Gensini score, a measure of coronary artery disease burden, is linked to left ventricular thrombus (LVT) formation after ST-segment elevation myocardial infarction (STEMI). This score aids in early risk stratification for LVT post-STEMI.

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.
Abstract

Keywords:
Gensini scoreacute ST-elevation myocardial infarctioncoronary angiographyleft ventricular thrombusrisk factors

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