Efficacy and Safety of Low Dose Rivaroxaban in Patients With Anterior Myocardial Infarction
Status:
Not yet recruiting
Trial end date:
2023-12-01
Target enrollment:
Participant gender:
Summary
Despite the use of guideline directed optimal medical therapy, 12% of patients with stable
coronary heart disease and 18% of patients with recent acute coronary syndrome experience
recurrent major adverse cardiovascular events 1. The risk of recurrent cardiovascular events
may be related to persistent elevation of thrombin beyond the index event 2,3
which leads to progression of cardiovascular disease by inducing inflammation, endothelial
dysfunction and thrombosis 4. In patients with coronary heart disease, vitamin K antagonists
(VKAs) and direct oral anticoagulants (DOACs) have been explored as secondary prevention
strategies and have shown cardiovascular benefits at the cost of higher bleeding events
5,6,7,8.
howeverLeft ventricular thrombus (LVT) usually appearswithin 1 month after ST-segment
elevation myocardial infarction (STEMI) and mostlyforms after anterior STEMI.9,11Although the
prevalenceof LVT after acute myocardial infarction hasdecreased dramatically in modern times
due to the progress of reperfusion therapy, LVT incidence in patients with anterior STEMI
remains at 4% to 26%.10,12 It complicates acute myocardial infarction and is associated with
a higher incidence of poor outcomes.9