Association of Anterior Ventricular Aneurysm and D-Dimer with Intracardiac Thrombus in Patients with Acute Myocardial Infarction: A Retrospective Analysis
- 1Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
- 2Department of Cardiovascular Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
- 3Biobank, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
Abstract
Background: Intracardiac thrombus is a clinically important complication of acute myocardial infarction (AMI), particularly in patients with ventricular aneurysm. We examined the contemporaneous associations of anterior ventricular involvement and D-dimer with echocardiographically documented intracardiac thrombus with incomplete chamber-specific localization among hospitalized AMI patients with ventricular aneurysm. Methods: This retrospective analysis included 1684 patients with documented ventricular aneurysm from a final cohort of 17,950 hospitalized AMI patients treated between January 2018 and October 2025. The first D-dimer measurement obtained at our hospital after AMI confirmation was used for D-dimer analyses. Ventricular aneurysm and intracardiac thrombus status were determined from the available echocardiographic documentation during the index hospitalization. Aneurysm locations were coded as linked patient-level, non-mutually exclusive indicators. Logistic regression evaluated anterior involvement; missing model covariates were multiply imputed and regression estimates were pooled using Rubin’s rules. Collinearity diagnostics and sensitivity analyses restricted to patients with apical aneurysm, including a complete-case analysis, were performed. Model-performance measures were interpreted as exploratory apparent performance in the development dataset. Results: Intracardiac thrombus was documented in 211 of 1684 patients (12.5%). Anterior involvement was more frequent among patients with thrombus than among those without thrombus (57.3% vs. 45.0%; p < 0.001) and remained associated with thrombus in the primary anatomical and clinical model (OR, 1.63; 95% CI, 1.20–2.21; p = 0.002). D-dimer was available in 1633 patients. On the log2-transformed scale, each doubling of D-dimer was associated with higher odds of echocardiographically documented intracardiac thrombus (adjusted OR, 1.24; 95% CI, 1.14–1.34; p < 0.001). As a complementary descriptive analysis, the observed thrombus proportion increased from 3.63% in Q1 to 22.30% in Q4; compared with Q1, the adjusted ORs were 3.71, 5.22, and 9.50 in Q2, Q3, and Q4, respectively. The combined model had a mean apparent AUC of 0.716, compared with 0.713 for the model containing D-dimer without anterior involvement; the mean absolute increment was approximately 0.003. Conclusions: Among hospitalized patients with AMI and ventricular aneurysm, higher D-dimer levels and anterior ventricular involvement were associated with echocardiographically documented intracardiac thrombus. Chamber-specific localization was incomplete, and these contemporaneous associations do not establish causality or prospective prediction. Anterior involvement provided minimal incremental discrimination beyond D-dimer.
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BibTeX
@article{li2026association,
title = {{Association of Anterior Ventricular Aneurysm and D-Dimer with Intracardiac Thrombus in Patients with Acute Myocardial Infarction: A Retrospective Analysis}},
author = {Bohan Li and Xiaorui Huang and Zizhu Lian and Shikang Liu and Tianyi Zhang and Tianjiao Lei and Guoliang Li and Yue Wu and Chaofeng Sun},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15208173},
url = {https://www.mdpi.com/2077-0383/15/20/8173},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Association of Anterior Ventricular Aneurysm and D-Dimer with Intracardiac Thrombus in Patients with Acute Myocardial Infarction: A Retrospective Analysis
AU - Bohan Li
AU - Xiaorui Huang
AU - Zizhu Lian
AU - Shikang Liu
AU - Tianyi Zhang
AU - Tianjiao Lei
AU - Guoliang Li
AU - Yue Wu
AU - Chaofeng Sun
PY - 2026
DA - 2026/10/01
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15208173
UR - https://www.mdpi.com/2077-0383/15/20/8173
AB - Background: Intracardiac thrombus is a clinically important complication of acute myocardial infarction (AMI), particularly in patients with ventricular aneurysm. We examined the contemporaneous associations of anterior ventricular involvement and D-dimer with echocardiographically documented intracardiac thrombus with incomplete chamber-specific localization among hospitalized AMI patients with ventricular aneurysm. Methods: This retrospective analysis included 1684 patients with documented ventricular aneurysm from a final cohort of 17,950 hospitalized AMI patients treated between January 2018 and October 2025. The first D-dimer measurement obtained at our hospital after AMI confirmation was used for D-dimer analyses. Ventricular aneurysm and intracardiac thrombus status were determined from the available echocardiographic documentation during the index hospitalization. Aneurysm locations were coded as linked patient-level, non-mutually exclusive indicators. Logistic regression evaluated anterior involvement; missing model covariates were multiply imputed and regression estimates were pooled using Rubin’s rules. Collinearity diagnostics and sensitivity analyses restricted to patients with apical aneurysm, including a complete-case analysis, were performed. Model-performance measures were interpreted as exploratory apparent performance in the development dataset. Results: Intracardiac thrombus was documented in 211 of 1684 patients (12.5%). Anterior involvement was more frequent among patients with thrombus than among those without thrombus (57.3% vs. 45.0%; p < 0.001) and remained associated with thrombus in the primary anatomical and clinical model (OR, 1.63; 95% CI, 1.20–2.21; p = 0.002). D-dimer was available in 1633 patients. On the log2-transformed scale, each doubling of D-dimer was associated with higher odds of echocardiographically documented intracardiac thrombus (adjusted OR, 1.24; 95% CI, 1.14–1.34; p < 0.001). As a complementary descriptive analysis, the observed thrombus proportion increased from 3.63% in Q1 to 22.30% in Q4; compared with Q1, the adjusted ORs were 3.71, 5.22, and 9.50 in Q2, Q3, and Q4, respectively. The combined model had a mean apparent AUC of 0.716, compared with 0.713 for the model containing D-dimer without anterior involvement; the mean absolute increment was approximately 0.003. Conclusions: Among hospitalized patients with AMI and ventricular aneurysm, higher D-dimer levels and anterior ventricular involvement were associated with echocardiographically documented intracardiac thrombus. Chamber-specific localization was incomplete, and these contemporaneous associations do not establish causality or prospective prediction. Anterior involvement provided minimal incremental discrimination beyond D-dimer.
SN - 2077-0383
ER -