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

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Heart & Lung Pub Date : 2024-05-15 DOI:10.1016/j.hrtlng.2024.04.019

Maryam Mehrpooya , Mohammad Rafi Barakzehi , Mahdi Nikoobakhsh

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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.

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评估直接口服抗凝剂与维生素 k 拮抗剂在治疗左心室血栓形成中的安全性和有效性。系统回顾和荟萃分析

背景自直接口服抗凝剂（DOACs）问世并与维生素 K 拮抗剂（VKAs）进行比较以来，关于左心室血栓形成（LVT）的最佳治疗方法，一直有相互矛盾的结果报道。方法系统检索了截至 2023 年 4 月 15 日所有比较 VKAs 和 DOACs 治疗左心室血栓疗效或安全性的临床试验和队列。与 VKA 相比，DOACs（尤其是利伐沙班和阿哌沙班）治疗左心室血栓的速度更快、死亡率更低、并发症（SSE 和出血事件）更少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart & Lung 医学-呼吸系统

CiteScore

4.60

自引率

3.60%

发文量

184

审稿时长

35 days

期刊介绍： Heart & Lung: The Journal of Cardiopulmonary and Acute Care, the official publication of The American Association of Heart Failure Nurses, presents original, peer-reviewed articles on techniques, advances, investigations, and observations related to the care of patients with acute and critical illness and patients with chronic cardiac or pulmonary disorders. The Journal''s acute care articles focus on the care of hospitalized patients, including those in the critical and acute care settings. Because most patients who are hospitalized in acute and critical care settings have chronic conditions, we are also interested in the chronically critically ill, the care of patients with chronic cardiopulmonary disorders, their rehabilitation, and disease prevention. The Journal''s heart failure articles focus on all aspects of the care of patients with this condition. Manuscripts that are relevant to populations across the human lifespan are welcome.