The Use of Anticoagulants in the Treatment of Acute Myocardial Infarction with Left Ventricular Thrombus
Clinical trials have been conducted for antithrombotic therapy after PCI in patients with atrial fibrillation who are taking anticoagulants. The trials which included the PIONEER AF-PCI, RE-DUAL PCI, AUGUSTUS, and ENTRUST-AF PCI trials compared direct oral anticoagulants (DOACs) with warfarin. The PIONEER AF-PCI, RE-DUAL PCI, AUGUSTUS, and ENTRUST-AF PCI trials showed that all four DOACs in combination with P2Y12 receptor antagonists reduced bleeding complications without increasing ischemic events, compared to warfarin and DAPT1). On the other hand, warfarin is recommended for anticoagulation after ACS and PCI in myocardial infarction patients with left ventricular or left atrial thrombus, patients with severe heart failure, patients with left ventricular mass, and patients that have undergone artificial valve replacement surgery (TAVR). In this issue, these cases are explained.
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