Randomized Study of Anti-Coagulation Therapy Using Rivaroxaban Added to Dual Anti-Platelet Treatment for Patients With Left Ventricular Thrombus After ST-Segment Elevation Myocardial Infarction

What this Trial Is About

Researchers are evaluating the best way to manage left ventricular thrombus LVT that develops after ST segment elevation myocardial infarction STEMI. LVT occurs in about 6% of STEMI patients, with a higher risk in certain cases like anterior STEMI with reduced heart function. Although anticoagulation is generally recommended, evidence is mostly observational and the benefits are unclear due to bleeding risks, especially when combined with dual antiplatelet therapy using potent P2Y12 inhibitors. This trial explores whether adding anticoagulation therapy to dual antiplatelet treatment improves outcomes in patients with LVT after STEMI. Participants are randomly assigned to one of two groups one group receives dual antiplatelet therapy plus rivaroxaban 15 mg daily, while the other group receives dual antiplatelet therapy alone. The choice of P2Y12 inhibitor is decided by the treating clinician. The study monitors patients for 12 months to compare outcomes including stroke, systemic embolism, bleeding events, thrombus resolution, and cardiac death. During the study, participants will undergo assessments to track the occurrence of stroke or embolism and monitor bleeding risks. Imaging tests like cardiac magnetic resonance or echocardiography confirm the presence and resolution of LVT. Researchers will evaluate major adverse events and monitor safety throughout the 12-month follow-up period. The trial aims to provide clearer guidance on anticoagulation use in this patient group while ensuring ongoing clinical care.

Anti-CoagulaTion on Left Ventricular Thrombus After ST Segment Elevation Myocardial Infarction