Journal article
Are direct oral anticoagulants preferable to warfarin for the treatment of left ventricular thrombi? A Bayesian meta-analysis of randomized controlled trials
American heart journal plus, Vol.12, pp.100066-100066
12/01/2021
DOI: 10.1016/j.ahjo.2021.100066
PMCID: PMC10978137
PMID: 38559599
Abstract
Background: There is no clear consensus on the optimal choice of anticoagulant in patients with left ventricular thrombi (LVT). Given the potentially fatal complications associated with this disease entity, we performed a systematic review and meta-analysis of recent randomized clinical trials (RCTs) to synthesize the latest evidence on this topic.Methods: We performed a comprehensive search of electronic databases to identify RCTs comparing warfarin to direct oral anticoagulants (DOACs) in patients with LVT. A random-effects Bayesian analysis using a binomialnormal hierarchical model was performed to compare the two treatment options with regards to the risk of mortality, stroke, LVT resolution, and major bleeding.Results: In an analysis comprising 3 RCTs (N = 139), there were no statistically significant differences regarding mortality (OR: 0.68; 95% CrI: 0.10 to 4.43), stroke (OR: 0.14; 95% CrI: 0.01 to 1.27), or LVT resolution (OR: 1.17; 95% CrI: 0.37 to 3.45). Major bleeding was significantly lower in the DOAC group (OR: 0.16; 95% CrI: 0.02 to 0.82).Conclusion: In patients with LVT, the currently available evidence from RCTs supports the use of DOACs rather than warfarin due to lower major bleeding risks and no evidence of inferiority with respect to mortality, stroke or LVT resolution.
Details
- Title: Subtitle
- Are direct oral anticoagulants preferable to warfarin for the treatment of left ventricular thrombi? A Bayesian meta-analysis of randomized controlled trials
- Creators
- Ahmed Sayed - Ain Shams UniversityMohanad Ghonim - Ain Shams UniversityMohamed Ghonim - Ain Shams UniversityAhmed K. Awad - Ain Shams UniversityYehia Saleh - Houston MethodistOmar M. Abdelfattah - Morristown Medical Center
- Resource Type
- Journal article
- Publication Details
- American heart journal plus, Vol.12, pp.100066-100066
- DOI
- 10.1016/j.ahjo.2021.100066
- PMID
- 38559599
- PMCID
- PMC10978137
- NLM abbreviation
- Am Heart J Plus
- ISSN
- 2666-6022
- eISSN
- 2666-6022
- Publisher
- Elsevier
- Number of pages
- 3
- Language
- English
- Date published
- 12/01/2021
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984755394102771
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