Direct Oral Anticoagulants Versus Warfarin for the Treatment of Left Ventricular Thrombus: A Multicenter...

Area of Science:

• Cardiology
• Pharmacology
• Thrombosis Research

Background:

• Left ventricular thrombus (LVT) management traditionally relies on Vitamin K antagonists (VKAs).
• The clinical effectiveness and safety of direct oral anticoagulants (DOACs) for LVT are not extensively documented.
• Establishing optimal anticoagulant therapy for LVT is crucial for patient outcomes.

Purpose of the Study:

• To compare the efficacy and safety of DOACs versus warfarin in patients diagnosed with LVT.
• To evaluate thrombus resolution rates, all-cause mortality, bleeding events, and thromboembolic events.

Main Methods:

• Multicenter retrospective analysis of adult patients with LVT from January 2015 to December 2021.
• Comparison of outcomes between patients treated with DOACs and those treated with warfarin.
• Propensity score matching and multivariate analysis were employed to control for confounding factors.

Main Results:

• No significant difference in thrombus resolution rates between DOACs (73.9%) and warfarin (68.5%) (p=0.489).
• Similar rates of all-cause mortality, bleeding events, and stroke or systemic embolism were observed between the two treatment groups.
• Propensity-matched analysis confirmed no significant difference in efficacy or safety outcomes between DOACs and warfarin for LVT treatment.

Conclusions:

• Direct oral anticoagulants (DOACs) demonstrate comparable efficacy and safety to warfarin in the treatment of left ventricular thrombus (LVT).
• Findings suggest DOACs are a viable alternative to warfarin for LVT management.
• Further prospective studies may be warranted to solidify these findings.