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Published on: February 28, 2012
Direct Oral Anticoagulants Versus Warfarin in Left Ventricular Thrombus: A Systematic Review and Meta-Analysis
Husam M Salah1, Akshay Goel, Prachi Saluja
1Division of Cardiology, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
Background:
There are conflicting results regarding the safety and efficacy of direct oral anticoagulants (DOACs) in the management of left ventricular thrombus (LVT) compared with the vitamin K antagonist warfarin.
Study Question:
What is the safety and efficacy of DOACs in the management of LVT compared with warfarin?
Data Source:
Randomized clinical trials and cohort studies in the MEDLINE and Cochrane databases from inception till April 4, 2021.
Study Design:
The present analysis is a systematic review and meta-analysis. Desired outcomes were all-cause mortality, complete resolution of LVT, stroke and systemic emboli, and major bleeding. The risk ratio (RR) of the outcomes and 95% confidence intervals (CIs) were calculated using a random-effects modeling approach.
Results:
Twelve studies with a total of 2322 patients were included. There was no difference between the 2 interventions in the resolution of LVT [RR 0.97 (CI 0.93-1.02)], stroke and systemic embolism [RR 0.95 (CI 0.63-1.45)], bleeding [RR 1.14 (CI 0.81-1.60)], and all-cause mortality [RR 0.99 (CI 0.67, 1.46)].
Conclusions:
DOACs and warfarin have comparable safety and efficacy outcomes in the management of LVT.
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