Alex McDonald: Much Needed Information on the Management of LVT
Alex McDonald, Clinical Pharmacy Specialist at Spartanburg Regional Healthcare System, reposted from RPTH Journal on LinkedIn:
”Much needed information on the management of LVT.
Stay tuned for more data regarding the use of the elevated intensity phase of apixaban (7 days) and rivaroxaban (21 day).
Prefer not to call it a loading dose since it is more for clot dynamics than for pharmacokinetics.”
Quoting RPTH Journal‘s post:
”Left ventricular thrombus (LVT) is a dangerous complication. Until now, we’ve had limited evidence on how DOACs compare with VKAs.
A new Mayo Clinic multi-site study of 182 patients sheds some light:
- DOACs and VKAs had similar rates of embolism and thrombus resolution.
- VKAs, however, carried more major bleeding.
- The first 8 weeks remain the highest-risk window for embolization — suggesting a loading dose of DOAC could be worth exploring.
Important data for anyone managing cardiomyopathy or LVT.”
Read the full article in RPTH.
Article: Comparison of direct oral anticoagulants and vitamin K antagonists in the treatment of left ventricular thrombi: a retrospective cohort study
Authors: Hossam Elbenawi, Kirsten Lipps, Samuel Heller Jr., David A. Liedl, Raymond C. Shields, Ana I. Casanegra, Stanislav Henkin, Thom W. Rooke, Paul W. Wennberg, Waldemar E. Wysokinski, Robert D. McBane, Damon E. Houghton
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