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Published on: February 28, 2012

Meta-Analysis of Randomised Controlled Trials on the Efficacy of Direct Oral Anticoagulants in Left Ventricular

Bernardo Resende1, Mariana Simões2, Gonçalo Ferraz-Costa3

  • 1Serviço de Cardiologia, Unidade Local de Saúde de Coimbra, Coimbra, Portugal. Electronic address: https://twitter.com/resende_lisboa.

Heart, Lung & Circulation
|July 2, 2026
PubMed

Insights

Direct oral anticoagulants (DOACs) are effective and safe for treating left ventricular thrombus (LVT), showing similar outcomes to warfarin. DOACs offer simpler management for LVT patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Medicine

Background:

  • Left ventricular thrombus (LVT) poses significant risks, with current treatments like direct oral anticoagulants (DOACs) and vitamin K antagonists lacking robust trial data.
  • Emerging evidence necessitates a re-evaluation of optimal anticoagulation strategies for LVT.

Purpose of the Study:

  • To systematically review and meta-analyze randomized controlled trials comparing DOACs with warfarin for LVT management.
  • To assess the efficacy and safety of DOACs versus warfarin in terms of thrombus resolution and bleeding events.

Main Methods:

  • Systematic search of three databases for randomized controlled trials comparing DOACs and warfarin.
  • Primary outcomes: overall thrombus resolution and major bleeding events.
  • Secondary outcomes: short-term thrombus resolution, all-cause mortality, and stroke. Data pooled using random-effects model.

Main Results:

  • Seven trials with 553 patients were analyzed.
  • No significant differences in overall thrombus resolution (RR=1.00) or major bleeding (RR=0.54) between DOACs and warfarin.
  • Similar rates for 1-month and 3-month thrombus resolution, all-cause mortality, and stroke.

Conclusions:

  • Direct oral anticoagulants (DOACs) demonstrate comparable efficacy and safety to warfarin for left ventricular thrombus (LVT) treatment.
  • DOACs present advantages in simpler dosing and management, making them a viable alternative for LVT.
  • The findings support DOACs as a preferred option for LVT management given their practical benefits.
Abstract

Keywords:
Direct oral anticoagulantsLeft ventricular thrombosisMeta-analysisVitamin K antagonists

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