AI Article Synopsis
- The study analyzed the effectiveness and safety of direct oral anticoagulants (DOACs) compared to vitamin K antagonists (VKAs) in treating patients diagnosed with left ventricular thrombus.
- A total of 99 patients were evaluated, with most receiving VKAs, and outcomes included rates of ischemic stroke, bleeding events, and resolution of the thrombus.
- Results showed no significant differences between the two groups in stroke incidents, bleeding events, or thrombus resolution, but the authors emphasized the need for further research through randomized clinical trials.
Article Abstract
Background: There is limited data on the efficacy of direct oral anticoagulants (DOACs) for the treatment of left ventricular thrombus. Currently, vitamin K antagonists (VKAs) remain the preferred oral anticoagulant for left ventricular thrombus. In this retrospective study, we assessed the safety and efficacy of DOACs in comparison to VKAs in patients with a new diagnosis of left ventricular thrombus.
Methods: We retrospectively identified all patients admitted to the 5 Catholic Health Initiative Omaha hospitals with a diagnosis of left ventricular thrombus between January 2012 and March 2019 and were discharged on oral anticoagulants. Patients were stratified into 2 groups: VKAs or DOACs and followed for up to 1 year. We compared the outcomes of ischemic stroke, bleeding, and echocardiographic resolution of left ventricular thrombus between the 2 groups.
Results: A total of 99 patients were included in this study (mean age: 61 years, 29% females). Of these, 80 (81%) were discharged on VKAs and 19 (19%) on DOACs. Stroke within 1 year of diagnosis occurred in 2 patients in the VKA group and none in the DOAC group (P = 0.49). Bleeding events were observed in 5 patients (4 in the VKA group and 1 in the DOAC group; P = 0.96). Ninety patients had follow-up echocardiogram; resolution of left ventricular thrombus was similar between the 2 groups (VKAs vs DOACs: 81% vs 80%; P = 0.9).
Conclusion: In patients with left ventricular thrombus, DOACs and VKAs had similar rates of stroke and bleeding. These findings need confirmation in randomized clinical trials.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.amjmed.2020.05.025 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Effect of heart rate on B-type natriuretic peptide in sinus rhythm.
Sci Rep
December 2024
Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8461, Japan.
B-type natriuretic peptide (BNP) levels accurately reflect the degree of cardiac overload in heart failure. Considering cardiac morphology and intracardiac pressure, including the left ventricular end-systolic volume index (LVESVI) and left ventricular end-diastolic volume index (LVEDVI), is essential for cardiac overload assessment. These indexes influence plasma BNP levels, and high heart rate is likely associated with cardiac morphology.
View Article and Find Full Text PDFEchocardiography-guided percutaneous intramyocardial septal radiofrequency ablation procedure for the treatment of Fabry disease: a case report.
Eur Heart J Case Rep
January 2025
Xijing Hypertrophic Cardiomyopathy Center, Department of Ultrasound, Xijing Hospital, Airforce Military Medical University, Xi'an, Shaanxi 710032, China.
Background: This is a case report of a patient with Fabry disease (FD). We successfully treated a patient with ventricular septal hypertrophy and left ventricular outflow tract (LVOT) obstruction caused by FD. We report our exclusive new surgery for patients with LVOT obstruction, percutaneous intramyocardial septal radiofrequency ablation (PIMSRA) procedure™ (percutaneous intramyocardial septal radiofrequency ablation).
View Article and Find Full Text PDFEarly Patient Outcome and Left Ventricular Function After Mitral Valve Replacement Using a Tilting Disc Mechanical Valve With Total Preservation of Mitral Valvular Apparatus.
Cureus
November 2024
Internal Medicine, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, IND.
Introduction The study aimed to retrospectively evaluate the early patient outcome and left ventricular function after mitral valve replacement with a tilting disc valve and total preservation. Patients and methods This retrospective observational study includes patients who underwent mitral valve replacement using a tilting disc valve with total preservation of mitral valvular and subvalvular apparatus from July 2021 to August 2022 at a single center. Results The data were reviewed retrospectively for age, sex, comorbidities, operating time, aortic cross-clamp time, cardiopulmonary bypass time, preoperative and postoperative left ventricular ejection fraction, mean gradient across the mitral valve, left ventricular diameter, left atrial size, atrial fibrillation, complications, mortality, and early patient outcome.
View Article and Find Full Text PDFNavigating the Dynamic Nature of Mitral Regurgitation With the Use of Multimodality Imaging in a Young Woman.
Cureus
November 2024
Cardiology, Mount Sinai West Hospital, New York, USA.
The mechanism and severity of mitral valve (MV) regurgitation (MR) play a critical role in guiding treatment decisions. Transthoracic echocardiography (TTE) is the primary diagnostic modality for evaluating MV disease. Discordant findings on TTE can be further quantified through transesophageal echocardiography (TEE).
View Article and Find Full Text PDFPost-traumatic Takotsubo Cardiomyopathy in a Pediatric Patient: A Rare Case and Diagnostic Challenge.
Cureus
November 2024
Anesthesia and Critical Care, Mohammed VI University Hospital, Tangier, MAR.
Takotsubo cardiomyopathy (TTC), also known as stress-induced cardiomyopathy, is a rare condition in children that causes acute, severe, but often reversible systolic dysfunction of the left ventricle. Physical trauma is a recognized trigger, although distinguishing TTC from myocardial contusion in pediatric trauma cases can be challenging due to overlapping clinical features. We present the case of a six-year-old boy involved in a high-impact motor vehicle collision.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!