Does heparin therapy prevent left ventricular thrombus formation and arterial embolism in patients with acute anterior myocardial infarction?
Left ventricular thrombus and arterial embolism are frequent complications of acute anterior myocardial infarction, and low-dose heparin does not appear to prevent them.
Abstract. To study left ventricular thrombus (LVT) formation and arterial embolism (AE), 106 consecutive patients with a first acute anterior myocardial infarction (AAMI) underwent two‐dimensional echocardiography before discharge. Repeated assessments for detection of AE were performed. Patients were non‐randomly allocated to either no heparin, low‐dose heparin or high‐dose heparin. LVT was found in 25 (26.9%) of 93 patients with technically satisfactory echocardiograms. Left ventricular (LV) wall motion impairment ( P = 0.0017) and treatment with either heparin or low‐dose heparin ( P = 0.0019) were independent predictors of LVT formation. AE, all strokes, occurred in 10 patients (9.4%) and was strongly associated with high age ( P = 0.0013). In conclusion. LVT and AE are frequent complications to AAMI. LV wall motion impairment predisposes for LVT and low‐dose heparin seems not to prevent these complications.
Kontny et al. (1993) studied this question.