The effect of thrombolytic therapy on the development of intraventricular thrombosis in acute myocardial infarction.

The authors studied the possibility to prevent the development of intraventricular thrombosis (IVT) following acute myocardial infarction (AMI) by application of early treatment of AMI, sought to identify the risk factors of IVT development, and were successful in reducing the potential of IVT to embolism by administration of appropriate therapy. A total of 200 patients with AMI were examined, with IVT diagnosed in 30 (15%). Results show that streptokinase treatment of AMI plays a role in preventing the development of IVT (1.0% incidence of IVT), with somewhat lesser protection conferred by heparin (with an incidence of 19%), and IVT present in 47% of cases when no thrombolytic or anticoagulation therapy had been administered. Of the risk factors making the patient susceptible to developing IVT, presence of an aneurysm, anteroseptal or apical AMI, decreased left ventricular ejection fraction and female sex were found to be statistically significant (p less than 0.05). Follow-up of IVT confirmed the risk of embolism in systemic arteries, especially in malignant IVT (p less than 0.01). In this case, anticoagulation therapy appears to be an effective therapeutic technique that must be initiated once the diagnosis has been established, and continued until 50% regression of the thrombus, or its complete disappearance.