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Thromb Haemost
DOI: 10.1055/a-2794-5001
Original Article: Coagulation and Fibrinolysis

Inherited Thrombophilia as a Risk Factor for Persistent Left Ventricular Thrombus Following Acute Myocardial Infarction

Authors

  • Krystian Mróz 

    1   Clinical Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland

  • Elżbieta Paszek

    1   Clinical Department of Interventional Cardiology, St. John Paul II Hospital, Krakow, Poland
    2   Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland

  • Ewa Wypasek

    3   Center for Innovative Laboratory Diagnostics, St. John Paul II Hospital, Krakow, Poland
    4   Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland

  • Anetta Undas

    2   Department of Thromboembolic Disorders, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
    5   Krakow Center for Medical Research and Technologies, St. John Paul II Hospital, Krakow, Poland

Funding Information This study was supported by the Jagiellonian University Medical College (K/ZDS/002936 to A.Undas).
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Graphical Abstract

Abstract

Background

Left ventricular thrombus (LVT) commonly complicates ST-segment elevation myocardial infarction (MI), and up to 30% of LVT may persist despite anticoagulation. Data linking post-MI LVT and inherited thrombophilias are sparse.

Methods

A total of 148 consecutive MI patients with LVT at a mean age of 63.9 (6.9) years were referred for further workup. After 3 months of oral anticoagulation, screening for factor V Leiden (FVL) and prothrombin G20210A variant, protein S, protein C, and antithrombin deficiency was performed. Subjects with antiphospholipid syndrome were not eligible. Thrombus persistence was assessed after 3 and 6 months of anticoagulation.

Results

Inherited thrombophilias were identified in 34 (23%) patients, including 18 (52.9%) with FVL, 9 (26.5%) with prothrombin G20210A variant, 3 (8.8%) with protein C deficiency, and 4 (11.8%) with protein S deficiency. Carriers of thrombophilias were similar to non-thrombophilic subjects, except for higher fibrinogen in the former group. Inherited thrombophilias were associated with LVT persistence after 3 and 6 months post MI (25 [73.5%] vs. 50 [43.9%], p = 0.002 and 20 [58.8%] vs. 24 [21.1%], p < 0.001, respectively). Inherited thrombophilias were independently associated with an increased risk of persistent LVT 3 and 6 months post MI (OR 2.75, 95% CI 1.13–6.74, p = 0.026 and OR 4.06, 95% CI 1.57–10.51, p = 0.004, respectively).

Conclusion

Our findings suggest that inherited thrombophilias may predispose to LVT persistence despite anticoagulation in MI survivors. Thrombophilia screening may help identify a subgroup likely to benefit from prolonged anticoagulation.

Keywords

inherited thrombophilia - left ventricular thrombus - myocardial infarction

Supplementary Material



Publication History

Received: 10 July 2025

Accepted: 21 January 2026

Article published online:
09 February 2026

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