{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:38:13Z","timestamp":1790732293307,"version":"4.1.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:00:00Z","timestamp":1721347200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T00:00:00Z","timestamp":1721347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Thrombosis J"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Introduction<\/jats:title>\n                <jats:p>This research is one of the pioneering randomized clinical trials (RCTs) aimed at assessing the effectiveness and safety of rivaroxaban in treating left ventricular thrombus (LVT) in patients who have experienced acute coronary syndrome (ACS).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Materials and methods<\/jats:title>\n                <jats:p>This is a randomized, controlled, interventional, open-label study. The patients were randomly divided into warfarin and rivaroxaban groups. We performed transthoracic echocardiography at the start of the study and again after three months to measure the thrombus area in square millimeters. The morphology of the thrombus was categorized into mural and round, and the mobility was classified into immobile, semi-mobile and hypermobile. We also monitored for adverse events including bleeding, systemic embolic occurrences, rehospitalization, and major adverse cardiac events (MACE).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The study included fifty-two patients in the intention-to-treat analysis, with an equal split between the rivaroxaban and warfarin groups (26 patients each). The average follow-up duration was three months. The thrombus resolution rates in the rivaroxaban (76.9%) and warfarin (69.2%) groups, as well as the thrombus size reduction, did not show statistical significance between groups. All semi-mobile or hypermobile thrombi transformed into immobile and all of the round LVTs changed into a mural in both rivaroxaban and warfarin groups. No significant difference was observed in bleeding complications and rehospitalization between the two groups.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The trial demonstrated that rivaroxaban is as effective as warfarin in terms of thrombus resolution rate, reduction in thrombus size, bleeding risk, and rehospitalization rate. Our findings suggest that rivaroxaban is a viable alternative to warfarin for managing left ventricular thrombus.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Graphical Abstract<\/jats:title>\n                \n              <\/jats:sec>","DOI":"10.1186\/s12959-024-00632-5","type":"journal-article","created":{"date-parts":[[2024,7,19]],"date-time":"2024-07-19T08:01:47Z","timestamp":1721376107000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Evaluation of the efficacy and safety of rivaroxaban compared to warfarin in patients with left ventricular apical thrombus: a randomized clinical trial"],"prefix":"10.1186","volume":"22","author":[{"given":"Pejman","family":"Mansouri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra Azamian","family":"Jazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Hadi","family":"Mansouri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooman","family":"Dehghan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reihaneh","family":"Zavar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyedeh Melika","family":"Hashemi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fereshteh","family":"Sattar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masoumeh","family":"Sadeghi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afshin","family":"Amirpour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morteza","family":"Abdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,19]]},"reference":[{"key":"632_CR1","doi-asserted-by":"crossref","unstructured":"Iqbal H, Straw S, Craven TP, Stirling K, Wheatcroft SB. Witte KKJEhf. Direct oral anticoagulants compared to vitamin K antagonist for the management of left ventricular thrombus. 2020;7(5):2032\u201341.","DOI":"10.1002\/ehf2.12718"},{"key":"632_CR2","doi-asserted-by":"crossref","unstructured":"Aljaber NN, Mattash ZA, Alshoabi SA, Alhazmi FHJPJMS. The prevalence of left ventricular thrombus among patients with low ejection fraction by trans-thoracic echocardiography. 2020;36(4):673.","DOI":"10.12669\/pjms.36.4.1972"},{"key":"632_CR3","doi-asserted-by":"crossref","unstructured":"Cochran JM, Jia X, Kaczmarek J, Staggers KA, Rifai MA, Hamzeh IR et al. Direct oral anticoagulants in the treatment of left ventricular thrombus: a retrospective, multicenter study and meta-analysis of existing data. 2021;26(2):173\u20138.","DOI":"10.1177\/1074248420967644"},{"key":"632_CR4","doi-asserted-by":"crossref","unstructured":"Lattuca B, Bouziri N, Kerneis M, Portal J-J, Zhou J, Hauguel-Moreau M et al. Antithrombotic therapy for patients with left ventricular mural thrombus. 2020;75(14):1676\u201385.","DOI":"10.1016\/j.jacc.2020.01.057"},{"key":"632_CR5","doi-asserted-by":"crossref","unstructured":"Zhou X, Shi R, Wu G, Zhu Q, Zhou C, Wang L et al. The prevalence, predictors, and outcomes of spontaneous echocardiographic contrast or left ventricular thrombus in patients with HFrEF. 2021;8(2):1284\u201394.","DOI":"10.1002\/ehf2.13196"},{"key":"632_CR6","doi-asserted-by":"crossref","unstructured":"McCarthy CP, Vaduganathan M, McCarthy KJ, Januzzi JL, Bhatt DL. McEvoy JWJJc. Left ventricular thrombus after acute myocardial infarction: screening, prevention, and treatment. 2018;3(7):642\u20139.","DOI":"10.1001\/jamacardio.2018.1086"},{"key":"632_CR7","doi-asserted-by":"crossref","unstructured":"Mega JL, Braunwald E, Wiviott SD, Bassand J-P, Bhatt DL, Bode C et al. 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