Thrombosis in the left ventricular cavity. Part 2. Treatment options

Main Article Content

O. I. Irkin
D. O. Bilyi

Abstract

Despite the long-standing problem of intracavitary thrombus formation, the question of treatment is still quite difficult for any clinician who encounters it. The doctor always has the choice of which of the anticoagulants to give preference to, when starting the treatment of blood clots. Errors in the selection of the drug and dosage cause a high risk of bleeding in the patient and on the other hand the risk of developing complications in the presence of thrombus formation in the left ventricular cavity.
Therefore, in our review, we decided to draw the attention of doctors to this problem by referring to and analyzing data from registries, meta-analyses, pilot and randomized multicenter clinical trials.

Article Details

Keywords:

thrombosis, anticoagulants, vitamin K antagonists, new oral anticoagulants, thrombus resolution

References

Abdelnabi M, Saleh Y, Fareed A, Nossikof A, Wang L, Morsi M, Eshak N, Abdelkarim O, Badran H, Almaghraby A. Comparative Study of Oral Anticoagulation in Left Ventricular Thrombi (No-LVT Trial). J Amer Coll Cardiol. 2021;77(12):1590-2. DOI: https://doi.org/10.1016/j.jacc.2021.01.049.

Abdullah Al-Abcha, Khader Herzallah, Yehia Saleh, et al. The Role of Direct Oral Anticoagulants Versus Vitamin K Antagonists in the Treatment of Left Ventricular Thrombi: A Meta-Analysis and Systematic Review. Am J Cardiovasc Drugs. 2021;21(4):435-41. DOI: https://doi.org/10.1007/s40256-020-00458-2.

Angkawipa Trongtorsak, Sittinun Thangjui, Jakrin Kew­­charoen, et al. Direct oral anticoagulants vs. vitamin K antagonists for left ventricular thrombus: a systematic review and meta-analysis. Acta Cardiol. 2021;76(9):933-42. DOI: https://doi.org/10.1080/00015385.2020.1858538.

Camilli M, et al. Direct oral anticoagulants vs. vitamin K antagonists for the treatment of left ventricular thrombosis: a systematic review of the literature and meta-analysis. Eur Heart J. Cardiovasc. Pharmacother. 2021;23;7(3):e21-e25. DOI: https://doi.org/10.1093/ehjcvp/pvaa134.

Dalia T, Lahan S, Ranka S, et al. Warfarin versus direct oral anticoagulants for treating left ventricular thrombus: a systematic review and meta-analysis. Thrombosis. J 2021;19:7. DOI: https://doi.org/10.1186/s12959-021-00259-w.

Fleddermann AM, Hayes CH, Magalski A, Main ML. Efficacy of direct acting oral anticoagulants in treatment of left ventricular thrombus. Am J Cardiol. 2019;124,367–72. DOI: https://doi.org/10.1016/j.amjcard.2019.05.009

He J, Ge H, Dong JX, Zhang W, et al. Rationale and design of a prospective multi-center randomized trial of EARLY treatment by rivaroxaban versus warfarin in ST-segment elevation MYOcardial infarction with Left Ventricular Thrombus (EARLY-MYO-LVT trial). Ann Transl Med. 2020;8(6):392. DOI: https://doi.org/10.21037/atm.2020.02.117

Hylek EM, Skates SJ, Shechan MA, Singer DE. An analysis of the lowest effective of prophylactic anticoagulation for patients with nonreumatic atrial fibrillation. N Engl J Med. 1996;335(8):540-6. DOI: https://doi.org/10.1056/NEJM199608223350802.

Kazuhiko Kido, Yasir Abdul Ghaffar, James C Lee, et al. Meta-analysis comparing direct oral anticoagulants versus vitamin K antagonists in patients with left ventricular thrombus. PLoS One. 2021;4;16(6):e0252549. DOI: https://doi.org/10.1371/journal.pone.0252549.

Lattuca B, et al. Antithrombotic therapy for patients with left ventricular mural thrombus. Am Coll Cardiology. 2020;75(14):1676-85. DOI: https://doi.org/10.1016/j.jacc.2020.01.057.

Makrides CA. Resolution of left ventricular postinfarction thrombi in patients undergoing percutaneous coronary intervention using rivaroxaban in addition to dual antiplatelet therapy. BMJ Case Rep. 2016:217843. DOI: https://doi.org/10.1136/bcr-2016-217843.

Mir T, Sattar Y, BinAttique H, et al. Meta-Analysis of direct oral anticoagulants compared with vitamin K antagonist for left ventricle thrombus. Cardiovascular Revascular. Med. 2022;35:141-6. DOI: https://doi.org/10.1016/j.carrev.2021.03.001.

Nso Nso, Kelechi E, et al. Direct Oral Anticoagulants (DOAC) versus Warfarin for the Treatment of Left Ventricular Thrombus (LVT) in Patients With or Without Cardiorenal Comorbidities, Including CKD (Chronic Kidney Disease) and Atrial Fibrillation: A Systematic Review and Meta-Analysis. Circulation. 2021;144:A12654. DOI: https://doi.org/10.1177/1060028020975111.

Robinson AA, et al. Off-label use of direct oral anticoagulants compared with warfarin for left ventricular thrombi. JAMA Cardiol. 2020;5:685–92. DOI: https://doi.org/10.1001/jamacardio.2020.0652.

Ronny Alcalai, et al. Apixaban vs. warfarin in patients with left ventricular thrombus: a prospective multicentre randomized clinical trial. Eur Heart J Cardiovasc Pharmacother. 2021;7(5):398-404. DOI: https://doi.org/10.1093/ehjcvp/pvab057.

Tetsuji Kitano, Yosuke Nabeshima, Masaharu Kata­­o­­ka, Masaaki Takeuchi. Therapeutic efficacy of direct oral anticoagulants and vitamin K antagonists for left ventricular thrombus: Systematic review and meta-analysis. PLoS One. 2021;26;16(7):e0255280. DOI: https://doi.org/10.1371/journal.pone.0255280.

Most read articles by the same author(s)

1 2 > >>