Rivaroxaban has been recently introduced for the management of non-valvular intra-cardiac thrombosis with variable results. We aimed to compare the results of the off-label use of rivaroxaban versus warfarin in the management of patients with left ventricle (LV) thrombus. This research is a retrospective study conducted on 63 patients who had LV thrombus from January to December 2016. We compared patients treated with warfarin (n=35) to patients who had rivaroxaban (n=28), and study outcomes were time to thrombus resolution, bleeding, stroke, and mortality. The median duration of treatment was 9.5 (25th-75th percentiles: 6-32.5) months for rivaroxaban and 14 (3-41) months for warfarin. Thrombus resolution occurred in 24 patients in the warfarin group (68.6%) and 20 patients in the rivaroxaban group (71.4%). The median time to resolution in the warfarin group was 9 (4-20) months and 3 (2-11.5) months in the rivaroxaban group. Thrombus resolution was significantly faster in patients on rivaroxaban (p= 0.019). Predictors of thrombus resolution were thrombus surface area (HR: 1.21; CI 95% (1.0-1.46); p= .048) and the use of rivaroxaban (HR: 1.92; CI 95% (1.01-3.65); p= 0.048). There was no difference in stroke, bleeding, and mortality between both groups. Rivaroxaban was as effective and safe as warfarin in managing patients with left ventricle thrombus. Larger randomized clinical trials are recommended to confirm our findings.

中文翻译：

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利伐沙班与华法林联合治疗左心室血栓

最近已引入利伐沙班用于治疗非瓣膜性心脏内血栓形成，但结果不一。我们旨在比较利伐沙班与华法林在患者左室血栓治疗中的标签外使用结果。这项研究是一项回顾性研究，研究对象是63名自2016年1月至2016年12月发生左室血栓的患者。我们比较了使用华法令（n = 35）和利伐沙班（n = 28）的患者，研究结果为血栓消退的时间，出血，中风和死亡率。利伐沙班的中位治疗时间为9.5（25-75％：6-32.5）个月，华法林为14（3-41）个月。华法林组24例（68.6％）和利伐沙班组20例（71.4％）发生血栓消退。华法林组中解决问题的中位时间为9（4-20）个月，利伐沙班组为3（2-11.5）个月。利伐沙班患者的血栓溶解明显更快（p = 0.019）。血栓溶解度的预测指标是血栓表面积（HR：1.21; CI 95％（1.0-1.46）; p = .048）和利伐沙班的使用（HR：1.92; CI 95％（1.01-3.65）; p = 0.048） 。两组之间的中风，出血和死亡率无差异。利伐沙班在治疗左心室血栓患者方面与华法林一样有效和安全。建议进行更大范围的随机临床试验以证实我们的发现。21; CI 95％（1.0-1.46）；p = .048）和利伐沙班的使用（HR：1.92； CI为95％（1.01-3.65）； p = 0.048）。两组之间的中风，出血和死亡率无差异。利伐沙班在治疗左心室血栓患者方面与华法林一样有效和安全。建议进行更大范围的随机临床试验以证实我们的发现。21; CI 95％（1.0-1.46）；p = .048）和利伐沙班的使用（HR：1.92； CI为95％（1.01-3.65）； p = 0.048）。两组之间的中风，出血和死亡率无差异。利伐沙班在治疗左心室血栓患者方面与华法林一样有效和安全。建议进行更大范围的随机临床试验以证实我们的发现。