Perfil clínico, diagnóstico y terapéutico de pacientes con trombo intraventricular izquierdo en tres centros de alta complejidad durante el período 2000-2022

Felipe Lozano Pineda; Carolina Cardona Buitrago; Santiago Giraldo Ramírez; Jairo Alfonso Gándara Ricardo; Edison Muñoz Ortiz; Catalina Gallego Muñoz; Juan David Valencia Duque; Edgar Alonso Mejía Guerra; Juan Nicolás Dallos Ferrerosa; Juan Manuel Senior Sánchez

doi:10.47487/apcyccv.v5i4.430

Authors

Felipe Lozano Pineda Departamento de Medicina Interna, Sección de Cardiología Clínica, Universidad de Antioquia; Medellín, Colombia; Unidad de Cardiología Clínica, Hospital Pablo Tobón Uribe; Medellín, Colombia. https://orcid.org/0000-0003-3498-3116
Carolina Cardona Buitrago Departamento de Medicina Interna, Sección de Cardiología Clínica, Universidad de Antioquia; Medellín, Colombia; Unidad de Cardiología Clínica, Hospital Alma Máter de Antioquia; Medellín, Colombia. https://orcid.org/0000-0002-0820-509X
Santiago Giraldo Ramírez Unidad de Cardiología Clínica, Hospital Pablo Tobón Uribe; Medellín, Colombia. https://orcid.org/0000-0001-7313-7778
Jairo Alfonso Gándara Ricardo Departamento de Medicina Interna, Sección de Cardiología Clínica, Universidad de Antioquia; Medellín, Colombia; Unidad de Cardiología clínica, Hospital Universitario San Vicente Fundación, Medellín, Colombia. https://orcid.org/0000-0003-0757-0033
Edison Muñoz Ortiz Departamento de Medicina Interna, Sección de Cardiología Clínica, Universidad de Antioquia; Medellín, Colombia; Unidad de Cardiología clínica, Hospital Universitario San Vicente Fundación, Medellín, Colombia. https://orcid.org/0000-0002-5156-7985
Catalina Gallego Muñoz Unidad de Cardiología Clínica, Clínica Cardio VID; Medellín, Colombia. https://orcid.org/0000-0002-3636-4346
Juan David Valencia Duque Unidad de Cardiología Clínica, Clínica Cardio VID; Medellín, Colombia. https://orcid.org/0009-0008-0749-8506
Edgar Alonso Mejía Guerra Fundación Universitaria San Martín; Medellín, Colombia. https://orcid.org/0009-0004-5257-2139
Juan Nicolás Dallos Ferrerosa Departamento de Medicina Interna, Sección de Cardiología Clínica, Universidad de Antioquia; Medellín, Colombia. https://orcid.org/0000-0001-9153-5526
Juan Manuel Senior Sánchez Departamento de Medicina Interna, Sección de Cardiología Clínica, Universidad de Antioquia; Medellín, Colombia; Servicio de Hemodinamia, Unidad Funcional Integrada Cardiopulmonar y Vascular periférica, Hospital Universitario San Vicente Fundación; Medellín, Colombia. https://orcid.org/0000-0001-8312-7194

DOI:

https://doi.org/10.47487/apcyccv.v5i4.430

Keywords:

Embolism and Thrombosis, Epidemiology, Anticoagulants, Prognosis

Abstract

Objective. To determine the clinical, diagnostic, and therapeutic profile of patients with left intraventricular thrombus (LVT) in three high-complexity centers in Medellín, Colombia, between January 2000 and January 2022. Materials and methods. This was an observational and cross-sectional study that included 307 patients with LVT. Hospital records were analyzed to identify the clinical and therapeutic profile, and thrombus resolution and systemic embolism were evaluated. Univariate and bivariate analyses were performed using Fisher's exact test and a logistic regression model. Results. The prevalence of LVT was 9.75%. In 85% of cases, LVT was diagnosed using transthoracic echocardiography; 75.9% of patients were male, and the median age was 62 years. The most frequent comorbidities were heart failure (95.77%) and hypertension (69.7%).LVT occurred in 27% of cases in the context of acute coronary syndrome (ACS). Low molecular weight heparin (LMWH) was administered in 78.5% of cases, and warfarin was the most commonly used anticoagulant (82.7%). Hemorrhagic complications occurred in 19.2%, mainly gastrointestinal, and 35% of patients achieved thrombus resolution. Systemic embolism developed in 30% of cases, primarily affecting the central nervous system. Overall mortality was 15%. Conclusions. The prevalence of LVT was 9.75%. Warfarin remains the standard treatment, although alternative therapies are used in special cases. Apical dysfunction was associated with systemic embolism.

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