Comparison of direct oral anticoagulants and vitamin K antagonists in the treatment of left ventricular thrombi: a retrospective cohort study
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11130%2F25%3A10504787" target="_blank" >RIV/00216208:11130/25:10504787 - isvavai.cz</a>
Result on the web
<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=CdpflGk0me" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=CdpflGk0me</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1016/j.rpth.2025.103192" target="_blank" >10.1016/j.rpth.2025.103192</a>
Alternative languages
Result language
angličtina
Original language name
Comparison of direct oral anticoagulants and vitamin K antagonists in the treatment of left ventricular thrombi: a retrospective cohort study
Original language description
Background: Left ventricular thrombus (LVT) is a serious thromboembolic complication in patients with cardiomyopathies. Evidence supporting direct oral anticoagulant (DOAC) therapy in LVT is limited. Objectives: We evaluated the effectiveness and safety of DOACs compared with vitamin K antagonists (VKAs) in patients with LVT. Methods: A multisite retrospective cohort study was performed, including patients with LVT diagnosed by echocardiography from 2018-2023 who were treated with either DOACs or VKAs. Primary outcome was the incidence of stroke and systemic embolism (SSE). Secondary outcomes included LVT resolution, major bleeding, and all-cause mortality. Results: A total of 182 patients with LVT met inclusion criteria, of which 70 (38.5%) were treated with only DOACs and 112 (61.5%) with only VKAs. The mean age was 66 years, and 74% of the patients were male. The median follow-up duration was 363.5 days (IQR, 139-950). No significant difference between the groups was observed in the incidence of SSE (DOAC, 5.7% vs VKA, 5.4%; P = 1.0), the incidence of LVT resolution (DOAC: 81.4% vs VKA: 87%; P = .35), the median time to LVT resolution (DOAC, 96 days vs VKA, 102 days; P = .22), or mortality (DOAC, 14.3% vs VKA, 11.6%; P = .6). However, VKAs were associated with a significantly higher incidence of major bleeding compared with DOACs (9% vs 1.4%; P = .02). Conclusion: LVT treated solely with either DOACs or VKAs had similar incidences of SSE, LVT resolution, time to LVT resolution, and mortality. VKA therapy, however, was associated with a higher incidence of major bleeding events.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30201 - Cardiac and Cardiovascular systems
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2025
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Research and Practice in Thrombosis and Haemostasis
ISSN
2475-0379
e-ISSN
2475-0379
Volume of the periodical
9
Issue of the periodical within the volume
7
Country of publishing house
US - UNITED STATES
Number of pages
11
Pages from-to
103192
UT code for WoS article
001607078900001
EID of the result in the Scopus database
2-s2.0-105019802509