Official journal of the Slovak Society of Cardiology,
Slovak Society of Hypertension and Slovak Association for Cardiac Arrhythmias

Cardiology Letters 2023, 32(4):262-270

Direct oral anticoagulants in the treatment of left ventricular thrombosis

Cingel M1, Focko B1, Nagy N1, Péč MJ1, Jurica J1, Bolek T1, Samoš M1, 2, Mokáň M1
1 I. interná klinika JLF UK a UNM, Jesseniova lekárska fakulta v Martine, Univerzita Komenského v Bratislave, Univerzitná nemocnica Martin
2 Oddelenia akútnej a intervenčnej kardiológie, Stredoslovenský ústav srdcových a cievnych chorôb (SÚSCCH), a. s. Banská Bystrica, Slovenská republika

Introduction: Left ventricular thrombosis is a relatively frequent and serious complication of ischemic and non-ischemic systolic left ventricular dysfunction. Current recommendations prefer vitamin K antagonists (VKA) in the treatment of left ventricular thrombosis (LVT). However, VKA therapy is connected with several limitations and risk and therefore there is an increasing interest in the use of direct oral anticoagulants (DOAC) in this indication. This article summarizes currently available data regarding the use of DOAC in the treatment of LVT.

Methodology: We searched PubMed, Web of Science, Scopus and Google Scholar databases to identify topic-relevant literature on patients presenting with LVT, its therapy and complications. The analysis was focused on thrombus resolution, rate of systemic embolism, stroke, mortality and bleeding complications.

Results and Conclusions: Currently available data suggest that there are no significant differences in safety and efficacy between DOAC and VKA anticoagulation in the treatment of LVT. However, there is a limited number of prospective studies directly comparing DOAC and VKA therapy. Our summary suggests that DOAC seems to be at least as efficient and safe as VKA in terms of systemic embolism, left ventricular thrombus resolution and risk of hemorrhage. Nevertheless, further relevant data from randomized control trials are needed for final recommendation of the use of DOAC in real-world clinical practice. Ref. 47, on-line full text (Free, PDF) www. cardiologyletters.sk

Keywords: left ventricular thrombus; direct oral anticoagulants; DOAC; antagonist of vitamin k; rivaroxaban; apixaban; edoxaban; dabigatran

Published: April 1, 2023  Show citation

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Cingel M, Focko B, Nagy N, Péč M, Jurica J, Bolek T, et al.. Direct oral anticoagulants in the treatment of left ventricular thrombosis. Cardiology Letters. 2023;32(4):262-270.
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