Why the study?
Left ventricular thrombus is a serious thromboembolic complication in cardiomyopathies, but evidence supporting direct oral anticoagulant therapy remains limited.
Does direct oral anticoagulant therapy prevent stroke and systemic embolism in patients with left ventricular thrombus compared to vitamin K antagonists?
Does direct oral anticoagulant therapy prevent stroke and systemic embolism in patients with left ventricular thrombus compared to vitamin K antagonists?
DOACs represent an effective alternative to VKAs for treating left ventricular thrombi, providing similar thromboembolic protection and thrombus resolution with a significantly lower risk of long-term major bleeding.
Background: Left ventricular thrombus (LVT) is a serious thromboembolic complication in patients with cardiomyopathies. Evidence supporting direct oral anticoagulant (DOAC) therapy in LVT is limited. Objectives: We evaluated the effectiveness and safety of DOACs compared with vitamin K antagonists (VKAs) in patients with LVT. Methods: A multisite retrospective cohort study was performed, including patients with LVT diagnosed by echocardiography from 2018-2023 who were treated with either DOACs or VKAs. Primary outcome was the incidence of stroke and systemic embolism (SSE). Secondary outcomes included LVT resolution, major bleeding, and all-cause mortality. Conclusion: LVT treated solely with either DOACs or VKAs had similar incidences of SSE, LVT resolution, time to LVT resolution, and mortality. VKA therapy, however, was associated with a higher incidence of major bleeding events.
No takes yet. Share an insight, caveat, or question.
Elbenawi et al. (2025) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: