Key result
Apixaban resulted in complete resolution of LV thrombus in 92.3% of patients compared to 100% with warfarin at 3 months, with no major bleeding events.
Why the study?
Vitamin K antagonists are currently recommended for left ventricular thrombus after acute MI, but prospective data on direct oral anticoagulants for this indication were lacking.
Does apixaban improve or prevent LV thrombus compared to warfarin in patients with LV thrombus post-MI?
Population
25 patients with LV thrombus detected 3 to 14 days after acute MI
Comparison
Apixaban 5 mg twice daily vs enoxaparin followed by dose-adjusted warfarin
Design
Prospective, randomized, multicenter open-label trial
Follow-up
3 months
Authors
Loading...
Provides first RCT data on DOACs versus VKA for post-MI LV thrombus; extends limited evidence and supports consideration as alternative.
RCT (n=25)
Open-label
randomized
Yes
Does apixaban improve or prevent LV thrombus compared to warfarin in patients with LV thrombus post-MI?
Absolute Event Rate: 92.3% vs 100%
In a preliminary prospective RCT, apixaban showed similar efficacy to warfarin for LV thrombus resolution post-MI with potentially fewer major bleeding events.
Alcalai et al. (2020) conducted an RCT in Left Ventricular (LV) Thrombus after acute MI (n=25). Apixaban vs. Enoxaparin followed by dose-adjusted warfarin was evaluated on Presence and size of LV thrombus 3 months after initiation of anticoagulation. Apixaban resulted in complete resolution of LV thrombus in 92.3% of patients compared to 100% with warfarin at 3 months, with no major bleeding events.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: