A Meta-Analysis Comparing Different Oral Anticoagulation for the Treatment of Ventricular Thrombus

Yang, Qing; He, Liyun; Quan, Xin; Yan, Lianshan

doi:10.31083/j.rcm2307243

Cited by 2 publications

(1 citation statement)

References 57 publications

(124 reference statements)

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“…Anticoagulants are recommended for patients with LVAT. 29 An early diagnosis of LVAT is important to initiate anticoagulation therapy to prevent thromboembolic disease. The MAPH score may be the new score for predicting LVAT in patients with anterior STEMI.…”

Section: Discussionmentioning

confidence: 99%

Relationship of MAPH Score with Left Ventricular Apical Thrombus and Adverse Events in Patients with Acute Anterior ST-Elevation Myocardial Infarction

Küçük,

Altınsoy

2023

ABC Heart Fail Cardiomyop

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Background: Left ventricular apical thrombus (LVAT) is a clinically crucial complication of anterior ST-elevation myocardial infarction (STEMI). The MAPH score is a newly developed thrombosis-related score. MAPH scores are simple scores that estimate blood viscosity and thrombus sensitivity. Objective: This study aimed to explore the relationship of MAPH score with LVAT and major adverse cardiovascular and cerebrovascular events (MACCE) in patients with acute anterior STEMI. Methods: The study included 185 patients with acute anterior STEMI who underwent percutaneous coronary intervention (PCI). LVAT was detected and divided into two groups in clinical follow-up after PCI. MAPH score obtained before PCI was compared between the groups, and its relationship with MACCE was examined. The MACCE included a combination of all-cause death, non-fatal myocardial infarction, target vessel revascularization, heart failure, and stroke. Results: MAPH score was higher in patients with LVAT than those without LVAT (p < 0.001). High MAPH score was determined to be a predictor of LVAT [odds ratio (OR): 1.265; 95% confidence interval (CI): 1.124-1.423; p < 0.001] and MACCE [hazard ratio (HR): 1.345; 95% CI: 0.984-1.790; p = 0.004] in patients with acute anterior STEMI. A high MAPH score was associated with a higher overall incidence of MACCE in Kaplan-Meier analyses. The cut-off values of the MAPH score for LVAT and MACCE were determined to be 2, based on receiver operating characteristic curve analysis. Conclusion: A high MAPH score may be used for LVAT and MACCE risk assessment in patients diagnosed with acute anterior STEMI.

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Section: Discussionmentioning

confidence: 99%

Relationship of MAPH Score with Left Ventricular Apical Thrombus and Adverse Events in Patients with Acute Anterior ST-Elevation Myocardial Infarction

Küçük,

Altınsoy

2023

ABC Heart Fail Cardiomyop

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Trial sequential analysis of efficacy and safety of direct oral anticoagulants and vitamin K antagonists against left ventricular thrombus

Kitano

Nabeshima

Kataoka

et al. 2023

Sci Rep

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Meta-analysis may increase the risk of random errors. Trial sequential analysis (TSA) has been developed to adjust for these random errors. We conducted TSA on the efficacy and safety of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) in left ventricular thrombus (LVT) patients in order to estimate how many additional patients should be required to draw definite conclusions. PubMed, Scopus, and Cochrane Library databases were searched for articles directly comparing DOACs and VKAs for LVT in LV thrombus resolution, stroke, any thromboembolism, major bleeding, any bleeding, and all-cause death. TSA was conducted with a cumulative Z-curve, monitoring boundaries, and required sample size. A simulated trial was run and TSA estimated the sample sizes of trials needed to draw definite conclusions. Of 4749 articles, 25 studies were used for the analysis. TSA revealed the current sample size already demonstrated superiority of DOACs in LV thrombus resolution and stroke, and futility in any thromboembolism and all-cause death. Two other outcomes did not achieve the required sample size. The sample size of new trials needed to demonstrate the superiority of DOACs over VKAs was estimated 400 for any bleeding. Corresponding trials needed to demonstrate no significant differences could be estimated for major bleeding and any bleeding (n = 200 and n = 2000, respectively). Current results show that the sample size required to draw definite conclusions was not reached for two outcomes, and there was a risk of random error. Further randomized controlled trials with sample sizes estimated by TSA will work effectively to obtain valid conclusions.

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A Meta-Analysis Comparing Different Oral Anticoagulation for the Treatment of Ventricular Thrombus

Cited by 2 publications

References 57 publications

Relationship of MAPH Score with Left Ventricular Apical Thrombus and Adverse Events in Patients with Acute Anterior ST-Elevation Myocardial Infarction

Relationship of MAPH Score with Left Ventricular Apical Thrombus and Adverse Events in Patients with Acute Anterior ST-Elevation Myocardial Infarction

Trial sequential analysis of efficacy and safety of direct oral anticoagulants and vitamin K antagonists against left ventricular thrombus

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