Objective: We aimed to compare the Outcomes and Safety of Rivaroxaban versus Warfarin for the treatment of left ventricular thrombus. Methodology: This Prospective, Cohort study was conducted at AFIC/NIHD Rawalpindi, from July 2022 to December 2022. 196 patients of both genders, aged between 40-80 years, diagnosed with left ventricular thrombus on Transthoracic echo (TTE), were included. Patients were divided into two treatment groups using stratified random sampling; warfarin-treated and rivaroxaban treated. The outcomes were assessed at 1, 3, and 5 months. Echocardiographic evidence of thrombus resolution defined the treatment outcome while Safety was assessed in terms of increasing bleeding risk. Results: The patients were equally divided into warfarin and rivaroxaban-treated group. The mean age was 56.29 ±11.04. Echocardiography was done on 1,3 and 5 months and revealed an odds ratio of 1.04(95%CI 0.62-2.13) for thrombus resolution when comparing warfarin to DOACS while the relative risk ratio(RR) of bleeding in patients was 1.2(95%CI 0.51-2.39)in patients treated with warfarin. Conclusions: DOACS appeared non-inferior to warfarin for treating LVT without difference in bleeding complications.

Left ventricular thrombus (LVT), Direct oral anticoagulants (DOAC)/ Novel oral anticoagulants (NOAC)s, Outcomes.