Scientific Poster Session I: Residents and Fellows Research-in-Progress

Residents and Fellows Research in Progress
  Saturday, November 11, 2023
  11:30 AM–01:00 PM

Abstract

Introduction: The American College of Cardiology (ACC) and American Heart Association (AHA) recommend treatment with warfarin for the management of left ventricular thrombus (LVT) as it has demonstrated benefit in reducing the risk of subsequent stroke or systemic embolism (SSE). Direct oral anticoagulants (DOACs) have become the preferred therapeutic anticoagulant for various indications, including venous thromboembolism, for their ease of administration and no required monitoring. However, limited data exists on if DOACs would be a viable treatment in patients with LVT.

Research Question or Hypothesis: Is there a difference between DOACs and warfarin in preventing SSE requiring hospitalization or in bleeding in patients with LVT?

Study Design: This multi-center, retrospective chart review evaluates adult patients diagnosed with LVT and treated with either warfarin or a DOAC at a community teaching hospital system between January 1, 2022 to December 31, 2022. Patients are excluded if they have contraindications for chronic anticoagulation, renal failure (CrCl < 15 mL/min), or switched agents during the treatment period.

Methods: Patients were identified using a Health Data Management report utilizing ICD-10 code (I51.3) for “intracardiac thrombosis, not elsewhere classified,” and ICD-10 code (I23.6) for “intracardiac thrombosis as current complication following acute myocardial infarction.” The primary efficacy outcome of this study is to determine if DOACs are as effective as warfarin in preventing SSE requiring hospitalization. The primary safety outcome of this study is to determine if there is a difference between DOACs and warfarin in prevalence of major bleeding. Other data collection parameters include patient demographics, comorbid conditions, use of antiplatelet therapy, anticoagulant agent selected, left ventricular ejection fraction at time of diagnosis, and all cause mortality. An alpha of 0.05 will be used and data will be analyzed using descriptive statistics, Fisher’s Exact, and chi-squared.

Results: Pending

Conclusion: Pending

Presenting Author

Tyler Kennedy PharmD
Ascension St. Vincent Hospital Indianapolis

Authors

Patrick Nelson PharmD
Ascension St. Vincent Hospital Indianapolis

Ashly Schuyler PharmD
Ascension St. Vincent Hospital Indianapolis