| Abstrakt: |
Introduction:Left ventricular thrombus (LVT) is common post-STEMI, with an incidence of as high as 26% in patients with anterior MI. AHA guidelines recommend systemic anticoagulation with warfarin for patients with LVT. However, the efficacy of direct oral anticoagulants (DOACs) compared to warfarin in the treatment of LVT is unknown.Hypothesis:Rates of embolic events and bleeding will be similar in LVT patients treated with DOACs compared to warfarin.Methods:Retrospective single institution study of all patients with LVT diagnosed between 2010 and 2021 and treated with an anticoagulant. The primary outcome was embolic events (stroke, TIA, and other systemic embolism). Secondary outcomes were all bleeding events, major and minor bleeding per International Society on Thrombosis and Haemostasis criteria, and all adverse outcomes. p<0.05 by Chi-square test was considered significant.Results:Included were 164 patients with LVT who received anticoagulation. Of those, 29 were prescribed DOACs and 135 warfarin. A similar percentage of patients on DOACs and warfarin had embolic events (6.9% and 6.7%, respectively, p=0.97). DOACs had a trend towards lower rates of bleeding events, major and minor bleeding, all adverse outcomes, and percentage of patients experiencing an adverse outcome (10.3% vs 25.2%, p=0.13).Conclusions:LVT patients treated with DOACs had a similar risk of embolic and bleeding events and a trend towards less bleeding compared to those treated with warfarin. |
