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Is it reasonable to consider the use of DOACs for LV thrombus management instead of coumadin?

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Do you consider the use of DOACs reasonable for managing LV thrombus instead of warfarin?

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3 Answers
Mednet Member
Mednet Member
Cardiology · Mercy Health The Heart Institute Fairfield
Answered on

I have no qualms whatsoever at using a DOAC instead of Vitamin K antagonist in this situation, provided that the patient doesn't have a mechanical valve.

Endothelium is endothelium, so mechanistically I don't see much of a difference between using a DOAC to prevent/treat an LAA thrombus versus an LV...

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Mednet Member
Mednet Member
Cardiology · University Medical Partners
Answered on · Updated on

You will not find a class I indication for using DOAC in LV thrombus because there is not likely to be a randomized, double-blinded clinical trial on this indication. The small number of patients involved will not provide enough quality data or incentive for the companies to apply for an additional ...

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Mednet MemberInvited Expert
Cardiology · Yale University School of Medicine
Answered on · Updated on

The current standard of care of LV thrombus is anticoagulation with warfarin. Use of DOACs for LV thrombi is an off-label indication and observational data has shown this to be inferior to warfarin. I would only consider DOAC in this situation for patients who refuse warfarin or cannot comply with t...

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