Non–vitamin K oral anticoagulants versus warfarin for the treatment of left ventricular thrombus

Introduction: Left ventricular thrombus (LVT) is associated with significant morbidity and mortality.Conventional treatment comprises warfarinmediated anticoagulation; it is unclear whether non-vitamin K oral anticoagulants (NOACs) exhibit comparable efficacy and safety.Limited data are available for Asian patients.This study compared NOACs with warfarin in terms of clinical efficacy and safety for managing LVT. Methods:Clinical and echocardiographic records were retrieved for all adult patients with echocardiography-confirmed LVT at a major regional centre in Hong Kong from January 2011 to January 2020.Discontinuation of anticoagulation by 1 year was recorded.Outcomes were compared between patients receiving NOACs and those receiving warfarin.Primary outcomes were cumulative mortality and net adverse clinical events (NACEs).Secondary outcomes were complete LVT resolution and percentage reduction in LVT size at 3 months.Results: Forty-three patients were included; 28 received warfarin and 15 received NOACs, with follow-up periods (mean ± standard deviation) of 20 ± 12 months and 22 ± 9 months, respectively (P=0.522).Use of NOACs was associated with