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Different Oral Antithrombotic Therapy for the Treatment of Ventricular Thrombus: An Observational Study from 2010 to

Qing Yang1, Xinyue Lang1,2, Xin Quan1

  • 1Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, National Center for Cardiovascular Diseases, No. 167 Beilishi Road, Xicheng District, Beijing 100037, China.

International Journal of Clinical Practice
|June 10, 2022
PubMed

Insights

Newer anticoagulants, novel oral anticoagulants (NOACs), demonstrated superior thrombus resolution in patients with ventricular tachycardia (VT) compared to warfarin (VKAs) or antiplatelet therapy (APT). NOACs also showed a similar safety profile, indicating potential benefits for VT management.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Pharmacology

Background:

  • Ventricular tachycardia (VT) is a serious arrhythmia often associated with cardiac thrombus formation.
  • Effective anticoagulation strategies are crucial for managing VT and preventing complications.
  • Current treatment options include vitamin K antagonists (VKAs), novel oral anticoagulants (NOACs), and antiplatelet therapy (APT).

Purpose of the Study:

  • To compare the efficacy and safety of NOACs, VKAs, and APT in patients with imaging-confirmed VT.
  • To determine the primary outcome of thrombus resolution rate.
  • To identify patient characteristics associated with unresolved thrombus.

Main Methods:

  • Retrospective observational study (2010-2019) at the National Center of Cardiovascular Diseases, China.
  • Inclusion of 463 patients with VT confirmed by imaging.
  • Cox proportional hazards regression models used to calculate hazard ratios (HR) for thrombus resolution and safety outcomes.

Main Results:

  • NOACs group showed significantly higher thrombus resolution within 12 months compared to VKAs (HR 2.13) and APT (HR 2.55) after adjustment.
  • No significant differences in bleeding rates, thromboembolism, or all-cause death were observed among the groups within 12 months.
  • Male sex, myocardial infarction (MI) with or without ventricular aneurysm, and coronary artery disease history were associated with unresolved thrombus.

Conclusions:

  • NOACs offer a higher rate of thrombus resolution in VT patients with a comparable safety profile to VKAs and APT.
  • Factors such as male gender and history of MI or CAD may predict unresolved thrombus.
  • Urgent need for large randomized controlled trials to validate these findings.
Abstract

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