Meta-Analysis of the Safety and Efficacy of Direct Oral Anticoagulants for the Treatment of Left Ventricular Thrombus

Background: Literature on the preferred anticoagulant for treating left ventricular thrombus (LVT) is lacking. Thus, our objective was to compare the efficacy of DOACs versus warfarin in treating LVT. Methods: Databases were searched for RCTs and adjusted observational studies that compared DOAC ver...

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Main Authors: Mounica Vorla (Author), Dinesh K. Kalra (Author)
Format: Book
Published: MDPI AG, 2024-05-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Mounica Vorla  |e author 
700 1 0 |a Dinesh K. Kalra  |e author 
245 0 0 |a Meta-Analysis of the Safety and Efficacy of Direct Oral Anticoagulants for the Treatment of Left Ventricular Thrombus 
260 |b MDPI AG,   |c 2024-05-01T00:00:00Z. 
500 |a 10.3390/ph17060708 
500 |a 1424-8247 
520 |a Background: Literature on the preferred anticoagulant for treating left ventricular thrombus (LVT) is lacking. Thus, our objective was to compare the efficacy of DOACs versus warfarin in treating LVT. Methods: Databases were searched for RCTs and adjusted observational studies that compared DOAC versus warfarin through March 2024. The primary efficacy outcomes of interest were LVT resolution, systemic embolism, composite of stroke, and TIA. The primary safety outcomes encompassed all-cause mortality and bleeding events. Results: Our meta-analysis including 31 studies demonstrated that DOAC use was associated with higher odds of thrombus resolution (OR: 1.08, 95% CI: 0.86-1.31, <i>p</i>: 0.46). A statistically significant reduction in the risk of stroke/TIA was observed in the DOAC group versus the warfarin group (OR: 0.65, 95% CI: 0.48-0.89, <i>p</i>: 0.007). Furthermore, statistically significant reduced risks of all-cause mortality (OR: 0.68, 95% CI: 0.47-0.98, <i>p</i>: 0.04) and bleeding events (OR: 0.70, 95% CI: 0.55-0.89, <i>p:</i> 0.004) were observed with DOAC use as compared to warfarin use. Conclusion: Compared to VKAs, DOACs are noninferior as the anticoagulant of choice for LVT treatment. However, further studies are warranted to confirm these findings. 
546 |a EN 
690 |a anticoagulants 
690 |a left ventricular thrombus 
690 |a embolism 
690 |a prescription 
690 |a major adverse cardiac events 
690 |a Medicine 
690 |a R 
690 |a Pharmacy and materia medica 
690 |a RS1-441 
655 7 |a article  |2 local 
786 0 |n Pharmaceuticals, Vol 17, Iss 6, p 708 (2024) 
787 0 |n https://www.mdpi.com/1424-8247/17/6/708 
787 0 |n https://doaj.org/toc/1424-8247 
856 4 1 |u https://doaj.org/article/15e7e95a7ae64ffbb719b9ffde0e2cb0  |z Connect to this object online.