A meta-summary of case reports of non-vitamin K antagonist oral anticoagulant use in patients with left ventricular thrombus

  • Aloysius Sheng-Ting Leow
  • Ching-Hui Sia
  • Benjamin Yong-Qiang Tan
  • Joshua Ping-Yun Loh
Article
  • 120 Downloads

Abstract

Left ventricular (LV) thrombus is commonly seen in patients with extensive anterior ST-elevation myocardial infarction. The standard of care for LV thrombus is anticoagulation with warfarin. However, there has been an increasing trend of case reports using non-vitamin K antagonist oral anticoagulants (NOAC) for the treatment of LV thrombus. This study aimed to perform a meta-summary of the literature to characterise and evaluate the safety and feasibility of using NOAC in patients with LV thrombus. We searched for articles published in four electronic databases: PubMed, EMBASE, Scopus and Google Scholar using an appropriate keyword/MeSH term search strategy. Twenty-four studies comprising 36 patients were included in the analysis. Rivaroxaban was used in majority of patients (47.2%), whilst Apixaban and Dabigatran were prescribed in 25.0% and 27.8% of patients respectively. The most commonly associated risk factor found was post-acute myocardial infarction in 15 patients (41.7%). LV thrombus resolution was met by most patients (87.9%), and the median duration of treatment to resolution was 30.0 days (IQR = 22.5–47.0). One non-fatal bleeding event (3.0%) and no embolic events were reported. The use of NOAC may have a role in the treatment of LV thrombus in selected patients. Further randomized controlled trials are needed to evaluate this treatment strategy.

Keywords

Anticoagulation Left ventricular thrombus NOAC Thrombosis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

11239_2018_1656_MOESM1_ESM.docx (38 kb)
Supplementary material 1 (DOCX 38 KB)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore
  2. 2.Department of CardiologyNational University Heart Centre, SingaporeSingaporeSingapore
  3. 3.Department of MedicineNational University Health SystemSingaporeSingapore
  4. 4.Department of Medicine, Yong Loo Lin School of MedicineNational University of SingaporeSingaporeSingapore

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