COMPARATIVE EFFICACY OF WARFARIN VERSUS NOACS IN RESOLVING LEFT VENTRICULAR THROMBUS POST-ACUTE MYOCARDIAL INFARCTION: A RETROSPECTIVE COHORT STUDY

Abstract

Background: Left ventricular (LV) thrombus formation is a significant complication post-acute myocardial infarction (MI), increasing the risk of ischemic stroke and systemic embolism. Traditionally, warfarin has been the standard treatment for LV thrombus, but novel oral anticoagulants (NOACs) offer potential benefits due to easier management and reduced monitoring requirements.
Objective: This study aims to compare the efficacy and safety of warfarin versus NOACs in resolving LV thrombus following acute MI.
Methods: We conducted a retrospective cohort study at a single center from January 1, 2023, to December 31, 2023. The study included patients diagnosed with acute MI and subsequent LV thrombus, treated with either warfarin or NOACs. The primary outcome was the resolution of LV thrombus assessed via imaging at 3 and 6 months. Secondary outcomes included the incidence of ischemic stroke and systemic embolization.
Results: Among 200 participants, thrombus resolution rates did not differ significantly between the warfarin (62.4%) and NOAC groups (52.6%) at 6 months. However, NOACs showed a faster resolution at the 3-month mark. No significant differences were observed in the rates of ischemic stroke or systemic embolization.
Conclusion: Both warfarin and NOACs are effective in treating LV thrombus post-MI. NOACs may offer a faster resolution, which could be clinically beneficial in settings where rapid reduction of embolic risk is crucial. The findings support the use of NOACs as a viable alternative to warfarin for managing LV thrombus, with implications for enhancing patient care and treatment outcomes.