Abstract 16259: Sex Related Differences in Clinical Presentation and Outcomes in Left Ventricular Thrombus

Introduction: Sex related differences in the etiology, clinical characteristics and outcomes in patients with left ventricular thrombus (LVT) are not well understood.

Methods: We developed a multi-center registry of patients diagnosed with LV thrombus by echocardiography between 1/1/2014-12/30/2020. Cases were retrospectively identified and baseline clinical characteristics, thrombus features, treatment, resolution and long-term outcomes were studied.

Results: Women constituted 27% of all patients (n=271, 29% African American). Compared to men, there were no significant differences in age at presentation (median age 60 years) or median LVEF at presentation (25%). Women were more likely to have nonischemic cardiomyopathy (52.6% vs 32.2%, p=0.02) and presented with thromboembolic event at time of diagnosis of LVT (27.3% vs 13.6%, p=0.008). There was no difference in use of vitamin K antagonists during the study period. During a median follow-up of 72 months, there was no significant difference in all-cause mortality or risk of stroke or arterial thromboembolism (figure 1A-B). In Cox regression analysis, age and LVEF at presentation, chronic kidney disease, malignancy and LVEF at presentation were significant predictors of long-term mortality.

Conclusions: There was no significant difference in all-cause mortality or risk of stroke or thromboembolism between men and women after diagnosis of LV thrombus.