Research progress on the efficacy of novel oral anticoagulant for left ventricular thrombus_West China Medical Journal

Authors：

ZHANG Yuda ^1,2 , YANG Fang ^1,2 , YIN Nianpei ^1,2 ,  YANG Ying ^1,2

1. Clinical Medical College, North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;
2. Department of Cardiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, P. R. China;

Corresponding author：

YANG Ying, Email: 18582547175@163.com

Keywords：

Novel oral anticoagulant; left ventricular thrombus; vitamin K antagonist; anticoagulant therapy

DOI：

10.7507/1002-0179.202410093

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Left ventricular thrombus (LVT) is a common complication of heart diseases such as myocardial infarction and heart failure. Vitamin K antagonist (VKA) is currently the main method for LVT, but its use requires frequent monitoring of coagulation indicators, which may lead to poor patient compliance. The novel oral anticoagulant (NOAC) is easy to administer and does not require monitoring of international normalized ratio or dietary restrictions. With the development of NOAC, the position of VKA for LVT may gradually be replaced in the future. This article provides a review of the comparative efficacy of NOAC and VKA for LVT in recent years, in order to provide new ideas for the clinical use of NOAC for LVT.

1.	Robinson AA, Jain A, Gentry M, et al. Left ventricular thrombi after STEMI in the primary PCI era: a systematic review and meta-analysis. Int J Cardiol, 2016, 221: 554-559.
2.	Haller PM, Kazem N, Agewall S, et al. Oral anticoagulation in patients with left ventricular thrombus: a systematic review and meta-analysis. Eur Heart J Cardiovasc Pharmacother, 2024, 10(5): 444-453.
3.	黄珍珍, 饶芳, 邓理湘, 等. 新型口服抗凝药物与华法林治疗左心室血栓的对照研究. 临床心血管病杂志, 2024, 40(8): 661-665.
4.	Hudec S, Hutyra M, Precek J, et al. Acute myocardial infarction, intraventricular thrombus and risk of systemic embolism. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2020, 164(1): 34-42.
5.	You J, Wang X, Wu J, et al. Predictors and prognosis of left ventricular thrombus in post-myocardial infarction patients with left ventricular dysfunction after percutaneous coronary intervention. J Thorac Dis, 2018, 10(8): 4912-4922.
6.	Pöss J, Desch S, Eitel C, et al. Left ventricular thrombus formation after ST-segment-elevation myocardial infarction: insights from a cardiac magnetic resonance multicenter study. Circ Cardiovasc Imaging, 2015, 8(10): e003417.
7.	Pizzetti G, Belotti G, Margonato A, et al. Thrombolytic therapy reduces the incidence of left ventricular thrombus after anterior myocardial infarction. Relationship to vessel patency and infarct size. Eur Heart J, 1996, 17(3): 421-428.
8.	Gianstefani S, Douiri A, Delithanasis I, et al. Incidence and predictors of early left ventricular thrombus after ST-elevation myocardial infarction in the contemporary era of primary percutaneous coronary intervention. Am J Cardiol, 2014, 113(7): 1111-1116.
9.	Garber AM, Mentz RJ, Al-Khalidi HR, et al. Clinical predictors and outcomes of patients with left ventricular thrombus following ST-segment elevation myocardial infarction. J Thromb Thrombolysis, 2016, 41(3): 365-373.
10.	Feldman JM, Frishman WH, Aronow WS. Review of the etiology, diagnosis, and management of left ventricular thrombus. Cardiol Rev, 2025, 33(1): 46-48.
11.	Camaj A, Fuster V, Giustino G, et al. Left ventricular thrombus following acute myocardial infarction: JACC state-of-the-art review. J Am Coll Cardiol, 2022, 79(10): 1010-1022.
12.	Vaitkus PT, Barnathan ES. Embolic potential, prevention and management of mural thrombus complicating anterior myocardial infarction: a meta-analysis. J Am Coll Cardiol, 1993, 22(4): 1004-1009.
13.	O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol, 2013, 61(4): e78-e140.
14.	Ibanez B, James S, Agewall S, et al. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J, 2018, 39(2): 119-177.
15.	Hoerbrand IA, Kraus MJ, Gruber M, et al. Favorable safety profile of NOAC therapy in patients after tricuspid transcatheter edge-to-edge repair. Clin Res Cardiol, 2024: 19.
16.	Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med, 2009, 361(12): 1139-1151.
17.	Keita I, Aubin-Auger I, Lalanne C, et al. Assessment of quality of life, satisfaction with anticoagulation therapy, and adherence to treatment in patients receiving long-course vitamin K antagonists or direct oral anticoagulants for venous thromboembolism. Patient Prefer Adherence, 2017, 11: 1625-1634.
18.	Chen A, Stecker E, A Warden B. Direct oral anticoagulant use: a practical guide to common clinical challenges. J Am Heart Assoc, 2020, 9(13): e017559.
19.	李秀芬, 葛振嵘, 帕尔哈提·吐尔逊. 利伐沙班与华法林治疗左心室心尖部血栓的疗效比较. 中国循环杂志, 2015(6): 559-561.
20.	Robinson AA, Trankle CR, Eubanks G, et al. Off-label use of direct oral anticoagulants compared with warfarin for left ventricular thrombi. JAMA Cardiol, 2020, 5(6): 685-692.
21.	Li S, Deng Y, Tong Y, et al. Assessment of non-vitamin K antagonist oral anticoagulants for the management of left ventricular thrombus. Clin Cardiol, 2021, 44(6): 754-760.
22.	Alcalai R, Butnaru A, Moravsky G, et al. Apixaban vs. warfarin in patients with left ventricular thrombus: a prospective multicentre randomized clinical trial. Eur Heart J Cardiovasc Pharmacother, 2022, 8(7): 660-667.
23.	黄世见. 比较不同剂量利伐沙班与华法林对左室血栓影响及其预后的研究. 长春: 吉林大学, 2022.
24.	卢辉, 迪力热巴·肉孜, 秦顺霞. 对比利伐沙班与华法林对心肌梗死后左室血栓的疗效研究. 兵团医学, 2023, 21(2): 35-37.
25.	周双林, 杜冲, 赵胜彪, 等. 不同类型口服抗凝药物治疗急性心肌梗死后左室附壁血栓的短期疗效观察. 中西医结合心脑血管病杂志, 2023, 21(9): 1674-1678.

1. Robinson AA, Jain A, Gentry M, et al. Left ventricular thrombi after STEMI in the primary PCI era: a systematic review and meta-analysis. Int J Cardiol, 2016, 221: 554-559.
2. Haller PM, Kazem N, Agewall S, et al. Oral anticoagulation in patients with left ventricular thrombus: a systematic review and meta-analysis. Eur Heart J Cardiovasc Pharmacother, 2024, 10(5): 444-453.
3. 黄珍珍, 饶芳, 邓理湘, 等. 新型口服抗凝药物与华法林治疗左心室血栓的对照研究. 临床心血管病杂志, 2024, 40(8): 661-665.
4. Hudec S, Hutyra M, Precek J, et al. Acute myocardial infarction, intraventricular thrombus and risk of systemic embolism. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, 2020, 164(1): 34-42.
5. You J, Wang X, Wu J, et al. Predictors and prognosis of left ventricular thrombus in post-myocardial infarction patients with left ventricular dysfunction after percutaneous coronary intervention. J Thorac Dis, 2018, 10(8): 4912-4922.
6. Pöss J, Desch S, Eitel C, et al. Left ventricular thrombus formation after ST-segment-elevation myocardial infarction: insights from a cardiac magnetic resonance multicenter study. Circ Cardiovasc Imaging, 2015, 8(10): e003417.
7. Pizzetti G, Belotti G, Margonato A, et al. Thrombolytic therapy reduces the incidence of left ventricular thrombus after anterior myocardial infarction. Relationship to vessel patency and infarct size. Eur Heart J, 1996, 17(3): 421-428.
8. Gianstefani S, Douiri A, Delithanasis I, et al. Incidence and predictors of early left ventricular thrombus after ST-elevation myocardial infarction in the contemporary era of primary percutaneous coronary intervention. Am J Cardiol, 2014, 113(7): 1111-1116.
9. Garber AM, Mentz RJ, Al-Khalidi HR, et al. Clinical predictors and outcomes of patients with left ventricular thrombus following ST-segment elevation myocardial infarction. J Thromb Thrombolysis, 2016, 41(3): 365-373.
10. Feldman JM, Frishman WH, Aronow WS. Review of the etiology, diagnosis, and management of left ventricular thrombus. Cardiol Rev, 2025, 33(1): 46-48.
11. Camaj A, Fuster V, Giustino G, et al. Left ventricular thrombus following acute myocardial infarction: JACC state-of-the-art review. J Am Coll Cardiol, 2022, 79(10): 1010-1022.
12. Vaitkus PT, Barnathan ES. Embolic potential, prevention and management of mural thrombus complicating anterior myocardial infarction: a meta-analysis. J Am Coll Cardiol, 1993, 22(4): 1004-1009.
13. O’Gara PT, Kushner FG, Ascheim DD, et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardiol, 2013, 61(4): e78-e140.
14. Ibanez B, James S, Agewall S, et al. 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J, 2018, 39(2): 119-177.
15. Hoerbrand IA, Kraus MJ, Gruber M, et al. Favorable safety profile of NOAC therapy in patients after tricuspid transcatheter edge-to-edge repair. Clin Res Cardiol, 2024: 19.
16. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med, 2009, 361(12): 1139-1151.
17. Keita I, Aubin-Auger I, Lalanne C, et al. Assessment of quality of life, satisfaction with anticoagulation therapy, and adherence to treatment in patients receiving long-course vitamin K antagonists or direct oral anticoagulants for venous thromboembolism. Patient Prefer Adherence, 2017, 11: 1625-1634.
18. Chen A, Stecker E, A Warden B. Direct oral anticoagulant use: a practical guide to common clinical challenges. J Am Heart Assoc, 2020, 9(13): e017559.
19. 李秀芬, 葛振嵘, 帕尔哈提·吐尔逊. 利伐沙班与华法林治疗左心室心尖部血栓的疗效比较. 中国循环杂志, 2015(6): 559-561.
20. Robinson AA, Trankle CR, Eubanks G, et al. Off-label use of direct oral anticoagulants compared with warfarin for left ventricular thrombi. JAMA Cardiol, 2020, 5(6): 685-692.
21. Li S, Deng Y, Tong Y, et al. Assessment of non-vitamin K antagonist oral anticoagulants for the management of left ventricular thrombus. Clin Cardiol, 2021, 44(6): 754-760.
22. Alcalai R, Butnaru A, Moravsky G, et al. Apixaban vs. warfarin in patients with left ventricular thrombus: a prospective multicentre randomized clinical trial. Eur Heart J Cardiovasc Pharmacother, 2022, 8(7): 660-667.
23. 黄世见. 比较不同剂量利伐沙班与华法林对左室血栓影响及其预后的研究. 长春: 吉林大学, 2022.
24. 卢辉, 迪力热巴·肉孜, 秦顺霞. 对比利伐沙班与华法林对心肌梗死后左室血栓的疗效研究. 兵团医学, 2023, 21(2): 35-37.
25. 周双林, 杜冲, 赵胜彪, 等. 不同类型口服抗凝药物治疗急性心肌梗死后左室附壁血栓的短期疗效观察. 中西医结合心脑血管病杂志, 2023, 21(9): 1674-1678.

West China Medical Journal

Latest ArticlesResearch progress on the efficacy of novel oral anticoagulant for left ventricular thrombus

Abstract Full text Figures/Tables Video References Cited by

Format

Content