Efficacy of non-vitamin-K antagonist oral anticoagulants for intracardiac thrombi resolution in nonvalvular atrial fibrillation

Abstract

Intracardiac thrombus is a potentially life-threatening condition associated with atrial fibrillation (AF), with a high risk of embolic complications. Oral anticoagulation (OAC) therapy is the first-line treatment for its prevention or resolution. For many patients, traditional OAC treatment using vitamin K antagonists (VKAs; e.g., warfarin) is limited by several factors and the advent of non-VKA oral anticoagulants (NOACs), with improved efficacy and safety profiles, has provided additional treatment options. However, studies are limited in number and are mostly case reports or series, with only one published modest-size prospective multicenter cohort study for rivaroxaban. No randomized controlled trials have been performed. Given the available data thus far, albeit weak, NOACs offer a possible alternative to VKAs for treating intracardiac thrombi.