Rivaroxaban versus warfarin for the management of left ventricle thrombus
Abstract Background Rivaroxaban has been recently introduced for the management of non-valvular intra-cardiac thrombosis with variable results. We aimed to compare the results of the off-label use of rivaroxaban versus warfarin in the management of patients with left ventricle (LV) thrombus. This re...
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doaj-6c6c78e103f645f69c528390258bb6b62021-05-02T11:25:38ZengSpringerOpenThe Egyptian Heart Journal2090-911X2021-05-017311610.1186/s43044-021-00164-7Rivaroxaban versus warfarin for the management of left ventricle thrombusMonirah A. Albabtain0Yahya Alhebaishi1Ola Al-Yafi2Hatim Kheirallah3Adel Othman4Haneen Alghosoon5Amr A. Arafat6Ahmed Alfagih7Pharmacy Department, Prince Sultan Cardiac CenterAdult Cardiology Department, Prince Sultan Cardiac CenterClinical Pharmacy Department, Al Maarefa CollegeAdult Cardiology Department, Prince Sultan Cardiac CenterAdult Cardiology Department, Prince Sultan Cardiac CenterCardiac Research Department, Prince Sultan Cardiac CenterAdult Cardiac Surgery Department, Prince Sultan Cardiac CenterAdult Cardiology Department, Prince Sultan Cardiac CenterAbstract Background Rivaroxaban has been recently introduced for the management of non-valvular intra-cardiac thrombosis with variable results. We aimed to compare the results of the off-label use of rivaroxaban versus warfarin in the management of patients with left ventricle (LV) thrombus. This research is a retrospective study conducted on 63 patients who had LV thrombus from January to December 2016. We compared patients treated with warfarin (n=35) to patients who had rivaroxaban (n=28), and study outcomes were time to thrombus resolution, bleeding, stroke, and mortality. Results The median duration of treatment was 9.5 (25th-75th percentiles: 6-32.5) months for rivaroxaban and 14 (3-41) months for warfarin. Thrombus resolution occurred in 24 patients in the warfarin group (68.6%) and 20 patients in the rivaroxaban group (71.4%). The median time to resolution in the warfarin group was 9 (4-20) months and 3 (2-11.5) months in the rivaroxaban group. Thrombus resolution was significantly faster in patients on rivaroxaban (p= 0.019). Predictors of thrombus resolution were thrombus surface area (HR: 1.21; CI 95% (1.0-1.46); p= .048) and the use of rivaroxaban (HR: 1.92; CI 95% (1.01-3.65); p= 0.048). There was no difference in stroke, bleeding, and mortality between both groups. Conclusion Rivaroxaban was as effective and safe as warfarin in managing patients with left ventricle thrombus. Larger randomized clinical trials are recommended to confirm our findings.https://doi.org/10.1186/s43044-021-00164-7Left ventricle thrombusNon-vitamin K dependent oral anticoagulant rivaroxabanWarfarin |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Monirah A. Albabtain Yahya Alhebaishi Ola Al-Yafi Hatim Kheirallah Adel Othman Haneen Alghosoon Amr A. Arafat Ahmed Alfagih |
spellingShingle |
Monirah A. Albabtain Yahya Alhebaishi Ola Al-Yafi Hatim Kheirallah Adel Othman Haneen Alghosoon Amr A. Arafat Ahmed Alfagih Rivaroxaban versus warfarin for the management of left ventricle thrombus The Egyptian Heart Journal Left ventricle thrombus Non-vitamin K dependent oral anticoagulant rivaroxaban Warfarin |
author_facet |
Monirah A. Albabtain Yahya Alhebaishi Ola Al-Yafi Hatim Kheirallah Adel Othman Haneen Alghosoon Amr A. Arafat Ahmed Alfagih |
author_sort |
Monirah A. Albabtain |
title |
Rivaroxaban versus warfarin for the management of left ventricle thrombus |
title_short |
Rivaroxaban versus warfarin for the management of left ventricle thrombus |
title_full |
Rivaroxaban versus warfarin for the management of left ventricle thrombus |
title_fullStr |
Rivaroxaban versus warfarin for the management of left ventricle thrombus |
title_full_unstemmed |
Rivaroxaban versus warfarin for the management of left ventricle thrombus |
title_sort |
rivaroxaban versus warfarin for the management of left ventricle thrombus |
publisher |
SpringerOpen |
series |
The Egyptian Heart Journal |
issn |
2090-911X |
publishDate |
2021-05-01 |
description |
Abstract Background Rivaroxaban has been recently introduced for the management of non-valvular intra-cardiac thrombosis with variable results. We aimed to compare the results of the off-label use of rivaroxaban versus warfarin in the management of patients with left ventricle (LV) thrombus. This research is a retrospective study conducted on 63 patients who had LV thrombus from January to December 2016. We compared patients treated with warfarin (n=35) to patients who had rivaroxaban (n=28), and study outcomes were time to thrombus resolution, bleeding, stroke, and mortality. Results The median duration of treatment was 9.5 (25th-75th percentiles: 6-32.5) months for rivaroxaban and 14 (3-41) months for warfarin. Thrombus resolution occurred in 24 patients in the warfarin group (68.6%) and 20 patients in the rivaroxaban group (71.4%). The median time to resolution in the warfarin group was 9 (4-20) months and 3 (2-11.5) months in the rivaroxaban group. Thrombus resolution was significantly faster in patients on rivaroxaban (p= 0.019). Predictors of thrombus resolution were thrombus surface area (HR: 1.21; CI 95% (1.0-1.46); p= .048) and the use of rivaroxaban (HR: 1.92; CI 95% (1.01-3.65); p= 0.048). There was no difference in stroke, bleeding, and mortality between both groups. Conclusion Rivaroxaban was as effective and safe as warfarin in managing patients with left ventricle thrombus. Larger randomized clinical trials are recommended to confirm our findings. |
topic |
Left ventricle thrombus Non-vitamin K dependent oral anticoagulant rivaroxaban Warfarin |
url |
https://doi.org/10.1186/s43044-021-00164-7 |
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