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Evaluation of the Safety and Efficacy of Direct Oral Anticoagulants Compared With Vitamin-K Antagonists in the Treatment of Left Ventricular Thrombosis. a Systematic Review and Meta-Analysis Publisher



Mehrpooya M1 ; Barakzehi MR2 ; Nikoobakhsh M3
Authors
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Authors Affiliations
  1. 1. Department of Cardiology, Imam Khomeini Hospital Complex of Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Cardiology, Tehran Heart center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of internal medicine, Yazd Islamic Azad University, Yazd, Iran

Source: Heart and Lung Published:2024


Abstract

Background: Since the introduction of direct oral anticoagulants (DOACs) and their comparison with vitamin K antagonists (VKAs), conflicting results have been reported regarding the optimal treatment for left ventricular thrombosis (LVT). Objectives: In this meta-analysis, we intend to comprehensively evaluate the safety and efficacy of these treatments. Methods: All clinical trials and cohorts that compared the efficacy or safety of VKAs with DOACs in the treatment of LVTs were systematically searched until April 15, 2023. Results: The results of 32 studies with a pooled sample size of 4213 patients were extracted for meta-analysis. DOACs, especially rivaroxaban and apixaban, cause faster resolution, lower mortality, and fewer complications (SSE and bleeding events) than VKAs in the management of LVTs. Conclusion: Compared with VKAs, DOACs result in significantly faster (only rivaroxaban) and safer resolution of left ventricular thrombosis. © 2024
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