左心室血栓
医学
华法林
血栓
心脏病学
射血分数
内科学
抗凝剂
管理策略
重症监护医学
心力衰竭
心房颤动
工商管理
业务
作者
Haowen Jiang,Fathima Aaysha Cader,M. Al-Omary,Lucky R. Cuenza,Purich Surunchupakorn,Ka Hei Ho,Jonathan Gabriel Sung,Sahlén Anders Olof,Jack Wei Chieh Tan,Jonathan Yap
出处
期刊:Journal of Asian Pacific Society of Cardiology
日期:2023-06-27
卷期号:2
被引量:2
标识
DOI:10.15420/japsc.2022.52
摘要
Although there is established evidence for the treatment of left ventricular thrombus (LVT) at the outset, the subsequent management of these patients is less well-defined. This review discusses the currently available evidence for the initial type and duration of anticoagulation for LVT and explores potential treatment options after the initial period of anticoagulation. Of 2,052 studies screened, 32 studies (with three randomised controlled trials) were included. The initial anticoagulation strategy was either warfarin or direct oral anticoagulants, with the majority of studies showing similar outcomes. If LVT persists, studies recommended continuing anticoagulation (n=11/17) or switching to a different class of anticoagulant (n=7/17). After resolution, five studies recommended continuing anticoagulation in the presence of high-risk features of recurrence (i.e. persistently depressed left ventricular ejection fraction and/or apical wall dyskinesia). Medical management should be optimised, together with the appropriate revascularisation strategy, as clinically indicated. Synthesising the evidence, a practical algorithm for the management of LVT is proposed.
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