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

Mehrpooya et al., 2024 | Heart Lung | Meta Analysis

Citation

Mehrpooya Maryam, Barakzehi Mohammad Rafi, Nikoobakhsh Mahdi. 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. Heart Lung. 2024;67:121-136. doi:10.1016/j.hrtlng.2024.04.019

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.

Key Findings

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.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 4213
Age Range See abstract
Condition See abstract

MeSH Terms

  • Humans
  • Vitamin K
  • Thrombosis
  • Heart Ventricles
  • Administration, Oral
  • Anticoagulants
  • Factor Xa Inhibitors
  • Rivaroxaban
  • Heart Diseases
  • Pyrazoles
  • Pyridones

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis
  • Vertical: vitamin-k

Provenance


Source extracted via PubMed E-utilities API on 2026-04-09