Evidence map›Paper›PMID 39082575›Full record

SynthesisArquivos brasileiros de cardiologia2024

Direct Oral Anticoagulants versus Vitamin K Antagonists for Left Ventricular Thrombus: A Meta-Analysis with Trial Sequential Analysis.

Eric Pasqualotto, Douglas Mesadri Gewehr, Rafael Oliva Morgado Ferreira, Matheus Pedrotti Chavez, Caroliny Hellen Silva, Sara Almeida Cruz, Jhonny Limachi-Choque, Amanda Park, Mário Sérgio Soares de Azeredo Coutinho, Luiz Fernando Kubrusly

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Arquivos brasileiros de cardiologia, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Eric PasqualottoUniversidade Federal de Santa Catarina, Florianópolis, SC - Brasil.ORCID 0000-0002-6484-1162
Douglas Mesadri GewehrFaculdade Evangélica Mackenzie do Paraná, Curitiba, PR - Brasil.ORCID 0000-0001-9393-2445
Rafael Oliva Morgado FerreiraUniversidade Federal de Santa Catarina, Florianópolis, SC - Brasil.ORCID 0000-0002-3203-0509
Matheus Pedrotti ChavezUniversidade Federal de Santa Catarina, Florianópolis, SC - Brasil.
Caroliny Hellen SilvaUniversidade Federal do Rio Grande do Norte, Natal, RN - Brasil.ORCID 0000-0001-8009-004X
Sara Almeida CruzImmanuel Kant Baltic Federal University Institute of Medicine, Kaliningrad - Rússia.ORCID 0000-0003-2814-9627
Jhonny Limachi-ChoqueUniversidad Mayor de San Simón - Centro Universitario de Medicina Tropical (CUMETROP), Cochabamba - Bolívia.ORCID 0000-0002-1869-2362
Amanda ParkCentro Universitário Lusíada - Faculdade de Ciências Médicas de Santos, Santos, SP - Brasil.ORCID 0000-0001-5142-7723
Mário Sérgio Soares de Azeredo CoutinhoUniversidade Federal de Santa Catarina, Florianópolis, SC - Brasil.ORCID 0000-0002-8025-9084
Luiz Fernando KubruslyFaculdade Evangélica Mackenzie do Paraná, Curitiba, PR - Brasil.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundVitamin K antagonists (VKAs) are the recommended first-line treatment for left ventricular thrombus (LVT); however, direct oral anticoagulants (DOACs) have been considered an alternative therapy.

objectivesTo evaluate the efficacy and safety of DOACs compared with VKAs therapy in patients with LVT.

methodsPubMed, Embase, and Cochrane were systematically searched for randomized clinical trials or cohort studies that compared DOACs versus VKAs for LVT. Risk ratios (RRs) were computed for binary endpoints, with 95% confidence intervals (95% CIs). Statistical significance was defined as p value < 0.05.

resultsA total of 4 randomized clinical trials and 29 cohort studies were included, with 4,450 patients assigned to either DOACs or VKAs. There was no significant difference between groups for stroke or systemic embolic (SSE) events (RR 0.84; 95% CI 0.65 to 1.07; p = 0.157), stroke (RR 0.73; 95% CI 0.48 to 1.11; p = 0.140), systemic embolic (SE) events (RR 0.69; 95% CI 0.40 to 1.17; p = 0.166), thrombus resolution (RR 1.05; 95% CI 0.99 to 1.11; p = 0.077), any bleeding (RR 0.78; 95% CI 0.60 to 1.00; p = 0.054), clinically relevant bleeding (RR 0.69; 95% CI 0.46 to 1.03; p = 0.066), minor bleeding (RR 0.73; 95% CI 0.43 to 1.23; p = 0.234), major bleeding (RR 0.87; 95% CI 0.42 to 1.80; p = 0.705), and all-cause mortality (RR 1.05; 95% CI 0.79 to 1.39; p = 0.752). Compared with VKAs, rivaroxaban significantly reduced SSE events (RR 0.35; 95% CI 0.16 to 0.91; p = 0.029) and SE events (RR 0.39; 95% CI 0.16 to 0.95; p = 0.037).

conclusionsDOACs had a similar rate of thromboembolic and hemorrhagic events, as well as thrombus resolution, compared to VKAs in the treatment of LVTs. Rivaroxaban therapy had a significant reduction in thromboembolic events, compared to VKAs.

Indexed as

AnticoagulantsHeart VentriclesThrombosisVitamin KAdministration, OralHeart DiseasesHemorrhageHumansRandomized Controlled Trials as TopicStrokeTreatment OutcomeAnticoagulantsVitamin K

Identifiers

PMID39082575
PMCPMC12080627

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.