DOACs vs Warfarin for Post-myocardial Infarction Left Ventricular Thrombus: A GRADE-assessed Meta-Analysis With Trial Sequential Analysis of Randomized Trials.

These results are in line with those of REWARF-STEMI trial, which observed that complete LVT resolution was achieved in approximately 81% of patients treated with DOACs compared with about 71% in those receiving VKAs, corresponding to a relative risk of 1.14 (95% CI 0.98–1.32), a difference that was not statistically significant but pointed toward a favorable trend. 19 Consistently, Chi et al in their meta-analysis reported no significant difference in resolution. 25 At the individual-trial level, Mansouri et al demonstrated rivaroxaban to be non-inferior to warfarin with similar reductions in thrombus size and no excess risk, while RIVAWAR trial reported >95% resolution in both arms of a contemporary post-MI RCT. 11 This effect can be understood through the action of factor Xa inhibition.

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