Anticoagulants; Increased Clinical Trial
Official title:
Comparative Study of Oral Anticoagulation in Patients With Left Ventricular Thrombi
Left ventricular (LV) thrombus is a common problem that is encountered in patients who
survived from a large myocardial infarction, and distal systemic embolization is the main
issue in these patients due to its major clinical consequences especially cerebrovascular
stroke.
Novel oral anticoagulants (NOACs) are now used safely in nonvalvular atrial fibrillation,
these agents were shown to be at least as effective as Vitamin K antagonists (VKA) such as
warfarin in prevention of systemic embolism, while having an improved safety profile with
less bleeding risk. However, the data about their usage for LV thrombi instead of the
commonly used VKA are still lacking except for case reports and small case series.
The proposed aim of this randomized observational clinical trial is to assess the efficacy of
the conventional anticoagulation in the form of warfarin and NOACs in the form of rivaroxaban
in the treatment of LV thrombus.
The proposed aim of this randomized observational clinical trial is to assess the efficacy of
the conventional anticoagulation in the form of warfarin and NOACs in the form of rivaroxaban
in the treatment of LV thrombus.
So patients with actual LV thrombus will be divided into 2 groups, one will receive the
traditional therapy which is warfarin with follow up of the INR in order to reach the desired
level of 2-3 then follow up every two weeks to determine the time in therapeutic range until
the end of the study follow up. The other group will receive oral rivaroxaban 20 mg per day
with follow up for the persistence or the disappearance of the LV thrombus one month, three
months and 6 months later.
As a secondary and safety end point, any major bleeding will be recorded as well as any
thrombo-embolic events
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