Background: To describe the
characteristics, treatment practices, and clinical outcomes of patients with
ventricular mural thrombus (VMT), with emphasis on the comparison of non-vitamin
K antagonist oral anticoagulants (NOACs) and vitamin K antagonists (VKAs).
Methods: We performed a retrospective cohort study between 2010 and 2019
in Fuwai Hospital, China. Patients with VMT newly treated with either NOACs or
VKAs were included. The primary outcome was the incidence rate of thrombus
resolution at 3 months. Results: We included 196 patients in total—68.9% (n = 135) were treated with VKAs while 31.1% (n = 61) were on NOACs.
Patients with a medical history of heart failure (HF) (odds ratio (OR) 2.10, 95%
confidence interval (CI) 1.17 to 3.77, p = 0.013) and a lower left
ventricular ejection fraction (OR 0.36, 95% CI 0.20 to 0.65, p = 0.001)
had a higher thrombus resolution. At 3 months, a significant difference was
observed in the thrombus resolution between the NOACs and VKAs group with or
without adjustment (OR 2.61, 95% CI 1.39 to 4.89, p = 0.003; adjusted
OR 2.93, 95% CI 1.51 to 5.66, p = 0.001). Further investigation
revealed that in the majority of the subgroups, individuals receiving NOAC
therapy had a superior thrombus resolution than those receiving VKA therapy.
Conclusions: Patients with a medical
history of HF or left ventricular ejection fraction
