The Use of Direct Oral Anticoagulants Compared to Vitamin K Antagonists [Warfarin] in Patients with Left Ventricular Thrombus

Document Type : Original Article

Authors

1 Department of Cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

2 Department of cardiology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

3 Department of Cardiology, National Heart Institute, Ministry of Health, Cairo, Egypt

Abstract

Background: Myocardial infarction [MI] and some non-ischemic cardiomyopathies are related to the development of left ventricular thrombus [LVT]. As recently as the pre-perfusion period, LVT rates after a MI varied from 21 percent to as high as 46 percent.
The Aim of the work: To compare the efficacy and safety of Direct Oral Anticoagulants [DOACs] versus Vitamin K Antagonists [VKA] [warfarin] in treatment of Left Ventricular thrombus.  
Patients and Methods: This clinical research was performed at the national heart institute from January 2022 to July 2023. This study was conducted on 120 patients with LV thrombus. All cases were separated into 3 groups: each group 40 individual [40 patients were treated with DOACs as Apixaban, 40 patients with Rivaroxaban & 40 patients with vitamin K antagonists as warfarin].
Results: INR showed a significant elevation in association with warfarin administration. There was a significant distinction seen across the groups in terms of, demographic data specific cardiac characteristics, ECG characteristics, thrombus characteristics and outcome of treatment.
Conclusion: DOACs [Rivaroxaban and Apixaban] and VKA [warfarin] have similar efficacy and safety in treating LVT.

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