Key result
NOAC therapy was associated with greater left ventricular thrombus resolution at 1 year compared to VKA (82% vs. 64.4%; OR 1.8, 95% CI 1.2-2.9; P=0.0018).
Why the study?
Guidelines recommend VKA for post-AMI LV thrombus, but NOACs are increasingly used off-label based on evidence from other indications without established safety and efficacy data in this setting.
Does NOAC therapy improve LV thrombus resolution compared to VKA in patients with left ventricular thrombus post-acute myocardial infarction?
Observational (n=101)
No
Does NOAC therapy improve LV thrombus resolution compared to VKA in patients with left ventricular thrombus post-acute myocardial infarction?
Odds Ratio: 1.8 (95% CI 1.2–2.9)
Absolute Event Rate: 82% vs 64.4%
p-value: p=0.0018
NOACs may offer improved LV thrombus resolution and a better safety profile compared to VKAs in patients with post-AMI LV thrombosis.
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May support off-label NOAC use post-AMI LV thrombus; leaves open need for RCTs to confirm safety and efficacy.
Jones et al. (2020) conducted an observational in Left ventricular thrombus post-acute myocardial infarction (n=101). Novel oral anticoagulants (NOACs) vs. Vitamin K antagonists (VKA) was evaluated on rate of LV thrombus resolution (OR 1.8, 95% CI 1.2-2.9, p=0.0018). NOAC therapy was associated with greater left ventricular thrombus resolution at 1 year compared to VKA (82% vs. 64.4%; OR 1.8, 95% CI 1.2-2.9; P=0.0018).
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