Safety And Efficacy of Direct Oral Anticoagulants Versus Warfarin for the Treatment of Left Ventricular Thrombus Open Access

Liu, Haoran (Spring 2020)

Permanent URL: https://etd.library.emory.edu/concern/etds/fb4949434?locale=en%255D
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Abstract

Abstract

Safety And Efficacy of Direct Oral Anticoagulants Versus Warfarin for the Treatment of Left Ventricular Thrombus

By Haoran Liu

Background: A left ventricular thrombus (LVT) is blood clot in the left ventricle with defined margins which blocks the blood vessel. Warfarin is the primarily used medication for LVT as current guidelines but need routine monitoring while direct oral anticoagulants (DOACs) are also attractive options. For now, clinical experiments for comparation between warfarin and DOACs are not enough.

Method and Materials: This study included 50 patients (19 to 87 years old) with a diagnosis of LV thrombus by ICD-9 or ICD-10 who were prescribed a DOAC or warfarin and the patients were followed through any visits  to Emory University Hospital and Emory University Hospital Midtown. T-test, chi-square test, Fisher exact test, logistics model and GLM model were used for statistical analysis.

Results: In the multivariate analysis, the odds ratio of resolving thrombus within 6 months of DOAC group was 2.29 higher than the Warfarin group, the chance of transient ischemic attack  after thrombus of DOAC group was 0.075 lower than Warfarin group, but the results were both not significant.

Conclusion: Though DOAC has better treatment effect on resolve the thrombus within 6 months compared with warfarin to some degree, which is not significant from the p-value ] and ROC analysis due to other factors like sample size. We need more patients to be enrolled in in the future research to get a more convincible result. 

Table of Contents

CONTENTS

1. INTRODUCTION...................................................................................1

2. METHODS AND MATERIALS .................................................................3

2.1 Patients and Observation parameter..................................................3

2.2 Statistical Analysis...........................................................................3

2.2.1 Descriptive analysis ......................................................................3

2.2.2 Univariate and Multivariate Regression Analysis …..........................4

2.3 ROC Analysis...................................................................................5

3.RESULTS...............................................................................................6

3.1 Results of Descriptive analysis..........................................................6

3.2 Results of Univariate analysis............................................................7

3.3 Results of Multivariate analysis.........................................................8

3.3.1 Logistic regression model for primary objective...............................8

3.3.2 Generalized linear model for secondary objective…..........................9

3.4 Results of ROC analysis ...................................................................10

4. CONCLUSION ......................................................................................10

5. DISCUSSION........................................................................................11

6. REFERENCE.........................................................................................13

7. TABLES AND FIGURES ..........................................................................15

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