CASE SERIES OF THE USE OF DIRECT ORAL ANTICOAGULANTS FOR LEFT VENTRICULAR THROMBUS

2019 ◽  
Vol 35 (10) ◽  
pp. S129
Author(s):  
G. Nanayakkara ◽  
J. Senaratne ◽  
S. Koshy ◽  
M. Senaratne
Keyword(s):  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Case Series ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus

scholarly journals A Case Series of Direct Oral Anticoagulants Use in Post-Infarction Left Ventricular Thrombus

2021 ◽  
Vol 33 (4) ◽  
pp. 19-23
Author(s):  
Tarique S. Chachar ◽  
Nooraldaem Yousif ◽  
Khurshid Ahmed ◽  
Tajammul Hussain ◽  
Haitham Amin
Keyword(s):  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Case Series ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Off Label Use ◽  
Mortality And Morbidity ◽  
Ventricular Thrombus ◽  
Current Guidelines

Left ventricular thrombus (LVT) is a known complication of acute myocardial infarction (AMI). Vitamin K antagonists such as Warfarin showed a reduction in associated mortality and morbidity and are indicated as anticoagulants of choice in current guidelines. Since their approval for clinical use, there has been a dramatic increase in off-label use of direct oral anti-coagulants (DOAC) for LVT. In this case series, the authors share their successful experience with DOAC in the treatment of LVT.

scholarly journals Efficacy of direct oral anticoagulants on the resolution of left ventricular thrombus—A case series and literature review

2019 ◽  
Vol 8 ◽  
pp. 204800401983954 ◽  
Author(s):  
Reem A Bahmaid ◽  
Shoroq Ammar ◽  
Sarah Al-Subaie ◽  
Mohammed A Soofi ◽  
Hassan Mhish ◽  
...  
Keyword(s):  
Randomized Clinical Trials ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Case Series ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Efficacy And Safety ◽  
Ventricular Thrombus ◽  
Institutional Review ◽  
Medical City

Background Left ventricular thrombus is a frequent complication of acute myocardial infarction and a risk factor for thromboembolic complications. Warfarin has been frequently used, but has some disadvantages that limit its use. Direct oral anticoagulants, in particular Dabigatran and Rivaroxaban have been proved to be effective in preventing thromboembolism among patients with non-valvular atrial fibrillation. However, no randomized clinical trials testing the efficacy and safety of these agents in patients with existing left ventricular thrombus. Furthermore, direct oral anticoagulants are still not approved by the Food and Drug Administration in the management of left ventricular thrombus. Method This study was a retrospective cohort assessing the efficacy of direct oral anticoagulants (Dabigatran or Rivaroxaban) on the resolution of left ventricular thrombus in patients taking either of these drugs during the study period from December, 2011 to December, 2016 at King Fahad Medical City. All patients’ records were reviewed and all patients who were diagnosed with left ventricular thrombus were included. Patients without available echocardiogram records were excluded. The study was approved by the institutional review board of King Fahad medical city, Riyadh Saudi Arabia. Result During the defined study period we found that 413 and 1218 patients were taking Dabigatran and Rivaroxaban, respectively. After filtering them based on the specialty of the prescriber, we ended up with 299 patients who have been started on Dabigatran and 448 patients who have been started on Rivaroxaban by cardiologists. Moreover, after reviewing echocardiogram reports for all of them (747 patients), we found that 11 patients were diagnosed to have left ventricular thrombus. Among those 11 patients, seven of them were treated with direct oral anticoagulants from the beginning and the remaining four patients were shifted from Warfarin to direct oral anticoagulants. All of them (7 patients) showed left ventricular thrombus resolution on follow-up echocardiogram. Conclusion Use of direct oral anticoagulants showed promising results in the resolution of left ventricular thrombus in patients diagnosed with left ventricular thrombus. Further studies at multiple health care centers are needed to further evaluate the efficacy and safety of direct oral anticoagulants as compared to traditional treatment in patients with left ventricular thrombus.

scholarly journals DIRECT ORAL ANTICOAGULANTS AS A TREATMENT FOR LEFT VENTRICULAR THROMBUS

CHEST Journal ◽  
2021 ◽  
Vol 160 (4) ◽  
pp. A264
Author(s):  
Nathaniel Hitt ◽  
Justin Putz ◽  
Christian Kladstrup ◽  
Derek Anderson ◽  
Russell Hamilton ◽  
...  
Keyword(s):  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus

scholarly journals Comparative Effectiveness of Direct Oral Anticoagulants and Warfarin for the Treatment of Left Ventricular Thrombus

2019 ◽  
Vol 25 (8) ◽  
pp. S26-S27 ◽  
Author(s):  
Megan Bass ◽  
Robert L. Page ◽  
Tyree H. Kiser ◽  
Colleen K. McIlvennan ◽  
Larry A. Allen ◽  
...  
Keyword(s):  
Comparative Effectiveness ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus

Efficacy of direct oral anticoagulants on left ventricular thrombus

2019 ◽  
Vol 30 (3) ◽  
pp. 96-103 ◽  
Author(s):  
Özge Turgay Yildirim ◽  
Ercan Akşit ◽  
Fatih Aydin ◽  
Ayşe Hüseyinoğlu Aydin
Keyword(s):  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Ventricular Thrombus

Direct Oral Anticoagulants in the Treatment of Left Ventricular Thrombus: A Retrospective, Multicenter Study and Meta-Analysis of Existing Data

2020 ◽  
pp. 107424842096764 ◽  
Author(s):  
John M. Cochran ◽  
Xiaoming Jia ◽  
Jessica Kaczmarek ◽  
Kristen A. Staggers ◽  
Mahmoud Al Rifai ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Left Ventricular ◽  
Left Ventricular Thrombus ◽  
Coronary Syndrome ◽  
Ventricular Thrombus ◽  
Existing Data

Aim: To compare the safety and efficacy of direct oral anticoagulants (DOAC) relative to vitamin K antagonists (VKA) for the treatment of left ventricular thrombus (LVT). Methods: This retrospective study enrolled patients diagnosed with LVT from 2014-2017. Patient characteristics and outcomes within 12 months of LVT diagnosis were recorded and analyzed. A meta-analysis was also performed by pooling our results with existing data in literature. Results: 14 DOAC and 59 VKA patients were included. Baseline demographic and clinical characteristics were similar except for age. Although more strokes within 12 months occurred in VKA (15%) than in DOAC (0%) patients, this was not statistically significant (p = 0.189). There were no significant differences in outcomes between patients on DOAC and VKA for acute coronary syndrome (ACS) (7%, vs 3.4%, p = .477), LVT resolution (86% vs 76%, p = .499) or bleeding (14% vs 14%, p = 1) within 12 months. The meta-analysis included 6 studies (n = 408 for DOACs; n = 1207 for VKA). There were no significant differences between DOACs versus VKAs with respect to odds for unresolved thrombus (OR 0.61, 95% CI 0.26,1.41), embolic events (OR 1.24, 95% CI 0.90,1.69), embolic events and death (OR 1.10, 95% CI 0.84,1.45) or bleeding events (OR 1.13, 95% CI 0.74,1.72). Conclusions: Our study and meta-analysis suggest similar efficacy and safety of DOACs in the treatment of LVT compared to VKA. These findings underscore the need for a randomized controlled trial.

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