{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,24]],"date-time":"2025-11-24T12:49:59Z","timestamp":1763988599460,"version":"build-2065373602"},"reference-count":37,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,13]],"date-time":"2025-04-13T00:00:00Z","timestamp":1744502400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: There are few data on anticoagulation therapy for left ventricular (LV) thrombosis following ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess whether microvascular obstruction (MVO) extent on cardiac magnetic resonance (CMR) worsened the prognosis of patients with LV thrombosis receiving anticoagulation. (2) Methods: reperfused STEMI patients undergoing CMR were enrolled. Patients were divided into 4 groups according to MVO and LV thrombosis presence or absence. Occurrence of major adverse cardiac events (MACE) was evaluated during follow-up. (3) Results: 80 STEMI patients were enrolled. According to MVO and LV thrombosis, 4 subgroups were obtained: patients with MVO and LV thrombosis (21 patients, 26%); patients with MVO without LV thrombosis (28 patients, 35%); patients without MVO with LV thrombosis (6 patients, 8%); patients without MVO and LV thrombosis (25 patients, 31%). All patients with LV thrombosis were treated with anticoagulation therapy. The median time to the follow-up was 11 months. Twenty-two patients (27%) experienced MACE. LV thrombosis treated with anticoagulation was an independent predictor of MACE (hazard ratio, 2.828; 95% confidence interval, 1.205\u20136.638; p = 0.017) and was associated with a worse prognosis (p = 0.012), regardless of MVO (p = 0.852), at Kaplan\u2013Meier. (4) Conclusions: Patients with LV thrombosis treated with anticoagulation after a reperfused STEMI have a worse prognosis than those without; however, MVO extent did not worsen prognosis.<\/jats:p>","DOI":"10.3390\/jcm14082658","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T04:42:07Z","timestamp":1744605727000},"page":"2658","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Intraventricular Thrombosis After Myocardial Infarction: Prognostic Evaluation in Relation to Microvascular Obstruction Extent by CMR"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4069-4177","authenticated-orcid":false,"given":"Antonella","family":"Cecchetto","sequence":"first","affiliation":[{"name":"Cardiology Unit, University of Padua-Azienda Ospedaliera, 35128 Padua, Italy"},{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6282-9399","authenticated-orcid":false,"given":"Francesco","family":"Zupa","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8926-187X","authenticated-orcid":false,"given":"Manuel","family":"De Lazzari","sequence":"additional","affiliation":[{"name":"Cardiology Unit, University of Padua-Azienda Ospedaliera, 35128 Padua, Italy"},{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angiola","family":"Bolis","sequence":"additional","affiliation":[{"name":"Unit of Cardiac Rehabilitation, ULSS 6 Euganea, 35020 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Baritussio","sequence":"additional","affiliation":[{"name":"Cardiology Unit, University of Padua-Azienda Ospedaliera, 35128 Padua, Italy"},{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4723-6646","authenticated-orcid":false,"given":"Stefano","family":"Nistri","sequence":"additional","affiliation":[{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy"},{"name":"Cardiology Service, CMSR Veneto Medica, 36077 Altavilla Vicentina, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9604-4686","authenticated-orcid":false,"given":"Giorgio","family":"De Conti","sequence":"additional","affiliation":[{"name":"Radiology Unit, University of Padua-Azienda Ospedaliera, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Perazzolo Marra","sequence":"additional","affiliation":[{"name":"Cardiology Unit, University of Padua-Azienda Ospedaliera, 35128 Padua, Italy"},{"name":"Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,13]]},"reference":[{"key":"ref_1","first-page":"100395","article-title":"Incidence and predictors of left ventricular thrombus formation following acute ST-segment elevation myocardial infarction: A serial cardiac MRI study","volume":"24","author":"Phan","year":"2019","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e003417","DOI":"10.1161\/CIRCIMAGING.115.003417","article-title":"Left Ventricular Thrombus Formation After ST-Segment\u2013Elevation Myocardial Infarction Insights From a Cardiac Magnetic Resonance Multicenter Study","volume":"8","author":"Desch","year":"2015","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1161\/CIRCIMAGING.109.897439","article-title":"Microvascular obstruction remains a portent of adverse remodeling in optimally treated patients with left ventricular systolic dysfunction after acute myocardial infarction","volume":"3","author":"Weir","year":"2010","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1093\/eurheartj\/ehv484","article-title":"Coronary microvascular obstruction in acute myocardial infarction","volume":"37","author":"Niccoli","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.jacc.2009.03.054","article-title":"Myocardial no-reflow in humans","volume":"54","author":"Niccoli","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"787","DOI":"10.1093\/cvr\/cvz301","article-title":"Pathophysiology and diagnosis of coronary microvascular dysfunction in ST-elevation myocardial infarction","volume":"116","author":"Konijnenberg","year":"2020","journal-title":"Cardiovasc. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1274","DOI":"10.1161\/01.CIR.62.6.1274","article-title":"The relationship of vascular injury and myocardial hemorrhage to necrosis after reperfusion","volume":"62","author":"Fishbein","year":"1980","journal-title":"Circulation"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s10554-011-9901-7","article-title":"Impact of microvascular obstruction and infarct size on left ventricular remodeling in reperfused myocardial infarction: A contrast-enhanced cardiac magnetic resonance imaging study","volume":"28","author":"Lombardo","year":"2012","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2660","DOI":"10.1093\/eurheartj\/ehq247","article-title":"Impact of early vs. late microvascular obstruction assessed by magnetic resonance on long-term outcome after ST-elevation myocardial infarction: A comparison with traditional prognostic markers","volume":"31","author":"Desch","year":"2010","journal-title":"Eur. Heart J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1016\/j.jcmg.2023.01.021","article-title":"Impact of Persistent Microvascular Obstruction Late After STEMI on Adverse LV Remodeling: A CMR Study","volume":"16","author":"Bodi","year":"2023","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1161\/01.CIR.93.2.223","article-title":"Clinical implications of the \u2018no reflow\u2019 phenomenon. A predictor of complications and left ventricular remodeling in reperfused anterior wall myocardial infarction","volume":"93","author":"Ito","year":"1996","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jacc.2005.09.008","article-title":"Effects of primary angioplasty for acute myocardial infarction on early and late infarct size and left ventricular wall characteristics","volume":"47","author":"Baks","year":"2006","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology","volume":"39","author":"Ibanez","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"520","DOI":"10.21037\/atm-20-7839","article-title":"Management of left ventricular thrombus: A narrative review","volume":"9","author":"Okajima","year":"2021","journal-title":"Ann. Transl. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1967","DOI":"10.1016\/S0140-6736(09)61751-7","article-title":"Risk of bleeding in patients with acute myocardial infarction treated with different combinations of aspirin, clopidogrel, and vitamin K antagonists in Denmark: A retrospective analysis of nationwide registry data","volume":"374","author":"Hansen","year":"2009","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1186\/s12968-018-0494-3","article-title":"Incidence and predictors of left ventricular thrombus by cardiovascular magnetic resonance in acute ST-segment elevation myocardial infarction treated by primary percutaneous coronary intervention: A meta-analysis","volume":"20","author":"Bulluck","year":"2018","journal-title":"J. Cardiovas. Magn. Reson."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1631\/jzus.B1200306","article-title":"Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage","volume":"14","author":"Qian","year":"2013","journal-title":"J. Zhejiang Univ.-Sci. B (Biomed. Biotechnol.)"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1136\/bmj.2.5402.177","article-title":"Human Experimentation: Code of Ethics of the World Medical Association","volume":"2","author":"Rickham","year":"1964","journal-title":"Br. Med. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1161\/01.CIR.97.8.765","article-title":"Prognostic Significance of Microvascular Obstruction by Magnetic Resonance Imaging in Patients With Acute Myocardial Infarction","volume":"97","author":"Wu","year":"1998","journal-title":"Circulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.jcmg.2014.06.012","article-title":"Effect of Microvascular Obstruction and Intramyocardial Hemorrhage by CMR on LV Remodeling and Outcomes After Myocardial Infarction","volume":"7","author":"Hamirani","year":"2014","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.ijcard.2021.11.050","article-title":"Risk score for early risk prediction by cardiac magnetic resonance after acute myocardial infarction","volume":"349","author":"Perez","year":"2022","journal-title":"Int. J. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1097\/RLI.0b013e3181e6f45c","article-title":"Prognostic value of microvascular damage determined by cardiac magnetic resonance in non ST-segment elevation myocardial infarction: Comparison between first-pass and late gadolinium-enhanced images","volume":"45","author":"Cochet","year":"2010","journal-title":"Investig. Radiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1007\/s00330-009-1395-5","article-title":"Prognostic impact of persistent microvascular obstruction as assessed by contrast-enhanced cardiac magnetic resonance in reperfused acute myocardial infarction","volume":"19","author":"Cochet","year":"2009","journal-title":"Eur. Radiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1016\/j.jcmg.2014.05.010","article-title":"Prognostic Value of Microvascular Obstruction and Infarct Size, as Measured by CMR in STEMI Patients","volume":"7","author":"Magro","year":"2014","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.jcmg.2009.03.011","article-title":"Prognostic value of a comprehensive cardiac magnetic resonance assessment soon after a first ST-segment elevation myocardial infarction","volume":"2","author":"Bodi","year":"2009","journal-title":"J. Am. Coll. Cardiol. Imaging"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1136\/hrt.2010.219543","article-title":"Growth-differentiation factor 15 as predictor of mortality in acute reperfused ST-elevation myocardial infarction: Insights from cardiovascular magnetic resonance","volume":"97","author":"Eitel","year":"2011","journal-title":"Heart"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1016\/j.jacc.2013.01.048","article-title":"Intracoronary compared with intravenous bolus abciximab application during primary percutaneous coronary intervention in ST-segment elevation myocardial infarction: Cardiac magnetic resonance substudy of the AIDA STEMI trial","volume":"61","author":"Eitel","year":"2013","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3502","DOI":"10.1093\/eurheartj\/ehx414","article-title":"Relationship between microvascular obstruction and adverse events following primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: An individual patient data pooled analysis from seven randomized trials","volume":"38","author":"Patel","year":"2017","journal-title":"Eur. Heart J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1016\/j.jacc.2014.06.1194","article-title":"Comprehensive prognosis assessment by CMR imaging after ST-segment elevation myocardial infarction","volume":"64","author":"Eitel","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.jcmg.2017.05.023","article-title":"Long-Term Incremental Prognostic Value of Cardiovascular Magnetic Resonance After ST-Segment Elevation Myocardial Infarction: A Study of the Collaborative Registry on CMR in STEMI","volume":"11","author":"Symons","year":"2018","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2369","DOI":"10.1007\/s00330-018-5895-z","article-title":"Microvascular obstruction extent predicts major adverse cardiovascular events in patients with acute myocardial infarction and preserved ejection fraction","volume":"29","author":"Galea","year":"2019","journal-title":"Eur. Radiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1186\/s43055-020-00202-5","article-title":"Prognostic value of microvascular occlusion MRI quantification in assessment of reperfused myocardial infarction","volume":"51","author":"Khafagy","year":"2020","journal-title":"Egypt. J. Radiol. Nucl. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1007\/s00059-008-3102-8","article-title":"Prognostic impact of contrast-enhanced CMR early after acute ST segment elevation myocardial infarction (STEMI) in a regional STEMI network: Results of the \u201cHerzinfarktverbund Essen\u201d","volume":"33","author":"Bruder","year":"2008","journal-title":"HERZ"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2459","DOI":"10.1016\/j.jacc.2010.02.033","article-title":"Predicting late myocardial recovery and outcomes in the early hours of ST-segment elevation myocardial infarction traditional measures compared with microvascular obstruction, salvaged myocardium, and necrosis characteristics by cardiovascular magnetic resonance","volume":"55","author":"Larose","year":"2010","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1161\/CIRCIMAGING.111.963421","article-title":"Dynamic changes of edema and late gadolinium enhancement after acute myocardial infarction and their relationship to functional recovery and salvage index","volume":"4","author":"Karia","year":"2011","journal-title":"Circ. Cardiovasc. Imaging"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1136\/hrt.2007.122622","article-title":"Infarct size by contrast enhanced cardiac magnetic resonance is a stronger predictor of outcomes than left ventricular ejection fraction or end-systolic volume index: Prospective cohort study","volume":"94","author":"Wu","year":"2008","journal-title":"Heart"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ijcard.2019.11.123","article-title":"Impact of infarct location and size on clinical outcome after ST-elevation myocardial infarction treated by primary percutaneous coronary intervention","volume":"301","author":"Reindl","year":"2020","journal-title":"Int. J. Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/8\/2658\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:13:36Z","timestamp":1760030016000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/8\/2658"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,13]]},"references-count":37,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["jcm14082658"],"URL":"https:\/\/doi.org\/10.3390\/jcm14082658","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,4,13]]}}}