{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:08:52Z","timestamp":1788480532040,"version":"build-2803163510"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":12,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Left ventricular (LV) thrombus carries a high risk of death and systemic embolism. While warfarin has been the standard treatment, evidence comparing direct oral anticoagulants (DOACs) with warfarin in this setting remains limited. This study aimed to compare real-world, risk-adjusted outcomes of DOAC vs. warfarin use in patients with LV thrombus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort analysis using the TriNetX research network database. Adults (\u226518 years) with echocardiographically confirmed LV thrombus from 2016 to 2022 were included. Patients with atrial fibrillation\/flutter, venous thromboembolism, end-stage renal disease, mechanical\/bioprosthetic valves, or therapy switch during follow-up were excluded. Propensity score matching (1:1) was used to balance covariates. The primary outcome was a composite of all-cause mortality and stroke\/transient ischaemic attack at 30 days and 1 year. Secondary outcomes included major bleeding and LV thrombus resolution. Of 2488 eligible patients (DOAC: 950; warfarin: 1538), 945 matched pairs were analysed with all baseline covariates balanced. In the DOAC group, 74% received apixaban and 26% rivaroxaban. At 30 days and 1 year, the composite outcome did not differ significantly between DOAC and warfarin [13.3% vs. 15%; matched hazard ratio (HR): 0.90, P = 0.41, and 23.8% vs. 26.7%; matched HR: 0.93, P = 0.46, respectively]. Major bleeding rates were similar at 30 days and 1 year (1.18% vs. 1.54%; matched HR: 0.77, P = 0.54, and 4.8% vs. 4.7%; matched HR: 1.13, P = 0.58, respectively). Thrombus resolution at 6 months occurred in \u223c81% of patients with follow-up imaging, with no difference by treatment group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a large propensity-matched cohort, DOACs and warfarin demonstrated comparable effectiveness and safety for LV thrombus management, supporting DOACs as a reasonable alternative.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjopen\/oeaf166","type":"journal-article","created":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T12:23:26Z","timestamp":1767615806000},"source":"Crossref","is-referenced-by-count":1,"title":["Direct oral anticoagulants vs. warfarin for left ventricular thrombus"],"prefix":"10.1093","volume":"6","author":[{"given":"Joseph","family":"Kassab","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, UT Southwestern Medical Center , Dallas, TX 75390 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Hajj","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, Sydell and Arnold Miller Family Heart Center, Department of Cardiovascular Medicine, Cleveland Clinic , Mail Code J2-3, 9500 Euclid Avenue, Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8849-7426","authenticated-orcid":false,"given":"Rishi","family":"Puri","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, Sydell and Arnold Miller Family Heart Center, Department of Cardiovascular Medicine, Cleveland Clinic , Mail Code J2-3, 9500 Euclid Avenue, Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serge C","family":"Harb","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, Sydell and Arnold Miller Family Heart Center, Department of Cardiovascular Medicine, Cleveland Clinic , Mail Code J2-3, 9500 Euclid Avenue, Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0026-3391","authenticated-orcid":false,"given":"Samir R","family":"Kapadia","sequence":"additional","affiliation":[{"name":"Heart and Vascular Institute, Sydell and Arnold Miller Family Heart Center, Department of Cardiovascular Medicine, Cleveland Clinic , Mail Code J2-3, 9500 Euclid Avenue, Cleveland, OH 44195 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"2026011303304978800_oeaf166-B1","doi-asserted-by":"crossref","first-page":"1010","DOI":"10.1016\/j.jacc.2022.01.011","article-title":"Left ventricular thrombus following acute myocardial infarction: JACC state-of-the-art review","volume":"79","author":"Camaj","year":"2022","journal-title":"J 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thrombi","volume":"5","author":"Robinson","year":"2020","journal-title":"JAMA Cardiol"},{"key":"2026011303304978800_oeaf166-B5","doi-asserted-by":"crossref","first-page":"101978","DOI":"10.1016\/j.jacadv.2025.101978","article-title":"Rivaroxaban vs warfarin in acute left ventricular thrombus following myocardial infarction","volume":"4","author":"Shah","year":"2025","journal-title":"JACC Adv"},{"key":"2026011303304978800_oeaf166-B6","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1093\/ehjcvp\/pvab057","article-title":"Apixaban vs. warfarin in patients with left ventricular thrombus: a prospective multicentre randomized clinical trial\u2021","volume":"8","author":"Alcalai","year":"2022","journal-title":"Eur Heart J Cardiovasc Pharmacother"},{"key":"2026011303304978800_oeaf166-B7","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1016\/j.jacc.2021.01.049","article-title":"Comparative study of oral anticoagulation in left ventricular thrombi (No-LVT 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guidelines for the management of acute coronary syndromes: developed by the task force on the management of acute coronary syndromes of the European Society of Cardiology (ESC)","volume":"44","author":"Byrne","year":"2023","journal-title":"Eur Heart J"}],"container-title":["European Heart Journal 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