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Efficacy of direct oral anticoagulants on left ventricular thrombus

Özge Turgay Yildirim1, Ercan Akşit2, Fatih Aydin1

  • 1Department of Cardiology, Eskisehir State Hospital, Eskisehir.

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|March 14, 2019
PubMed

Insights

Direct oral anticoagulants (DOACs) show promise as an alternative to warfarin for treating left ventricular thrombi (LVT). This review compiles case reports, highlighting DOACs

Area of Science:

  • Cardiology
  • Internal Medicine
  • Pharmacology

Background:

  • Left ventricular thrombus (LVT) is a significant complication associated with myocardial infarction and various cardiomyopathies.
  • Current guidelines recommend warfarin for LVT management.
  • Emerging evidence suggests direct oral anticoagulants (DOACs) as a potential alternative therapy.

Purpose of the Study:

  • To review and synthesize existing case reports on the use of DOACs for treating left ventricular thrombi.
  • To evaluate the efficacy and safety of DOACs in diverse clinical scenarios leading to LVT.

Main Methods:

  • Systematic literature search for case reports involving DOACs and LVT.
  • Analysis of patient demographics, underlying conditions, DOAC used, dosage, and outcomes.
  • Compilation of reported treatment responses and adverse events.

Main Results:

  • DOACs have been utilized in various conditions causing LVT, including myocardial infarction and cardiomyopathies.
  • Reported cases indicate potential efficacy and favorable safety profiles of DOACs in LVT treatment.
  • No large-scale randomized controlled trials currently exist to confirm these findings.

Conclusions:

  • DOACs represent a viable alternative to warfarin for LVT, supported by accumulating case report evidence.
  • Further research, including randomized controlled trials, is warranted to establish definitive guidelines for DOAC use in LVT.

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