Direct Oral Anticoagulants and Left Ventricular Thrombosis: The Evidence for a Good Therapeutic Approach

Even considering the great strides made in cardiovascular therapy during the past 10 years, intraventricular thrombosis still represents a clinical challenge. An accurate detection of left ventricular thrombosis (LVT) and early initiation of a proper antithrombotic therapy are of absolute importance in preventing potentially life-threatening complications. There are no high-quality studies that address the issue of the optimal anticoagulant regimen in patients with left ventricular thrombosis; moreover, the role of new potent antiplatelet drugs has not been evaluated in randomized trials. Warfarin remains the most commonly used oral anticoagulant while DOACs should be taken under consideration due to convenience in dosing and achieving therapeutic anticoagulation so long as there is no specific indication for warfarin.