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Reduced-Dose Apixaban in the Treatment of Left Ventricular Thrombus: A Report of 2 Cases

Adrienne E Bundrick1, Riley D Bowers2, Scott L Perkins2

  • 1Cape Fear Valley Medical Center, Medical University of South Carolina, Fayetteville, NC, USA.

Journal of Pharmacy Practice
|December 8, 2022
PubMed

Insights

Direct oral anticoagulants (DOACs) show promise as an alternative to warfarin for treating left ventricular (LV) thrombus. This case series suggests reduced-dose DOACs may be a safe and effective option for LV thrombus management.

Area of Science:

  • Cardiology
  • Hematology
  • Pharmacology

Background:

  • Warfarin has been the standard anticoagulant for left ventricular (LV) thrombus.
  • Direct oral anticoagulants (DOACs) offer advantages like less monitoring and fewer interactions.
  • DOACs lack FDA approval for LV thrombus but are increasingly studied.

Purpose of the Study:

  • To evaluate the use of DOACs as an alternative to warfarin for LV thrombus treatment.
  • To present case studies of patients treated with DOACs for LV thrombus.

Main Methods:

  • Review of recent studies on DOACs for LV thrombus.
  • Case series of two patients diagnosed with LV thrombus.
  • Patients treated with reduced-dose apixaban (2.5 mg twice daily).

Main Results:

  • Both patients tolerated reduced-dose apixaban without LV thrombus or treatment complications.
  • This suggests DOACs may be a viable alternative to warfarin.

Conclusions:

  • Reduced-dose DOACs represent a potential alternative to warfarin for LV thrombus treatment.
  • Further research and clinical trials are warranted to confirm efficacy and safety.

Keywords:
anticoagulationcardiology

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