Century Clot-Guided Prophylactic Rivaroxaban for Post STEMI Complicating Left Ventricular Thrombus
STEMI - ST Elevation Myocardial Infarction
About this trial
This is an interventional prevention trial for STEMI - ST Elevation Myocardial Infarction focused on measuring Century Clot analyzer; Prophylactic; Rivaroxaban; LVT; STEMI
Eligibility Criteria
Inclusion Criteria: Ischemic chest discomfort for at least 30 minutes, with at least 1-mm (0.1-mv) ST-segment elevation in anterior leads on a standard 12-lead electrocardiogram. Patients provide written informed consent prior to enrollment. Exclusion Criteria: Intracranial, gastrointestinal, or urogenital bleeding within 6 months Requiring OAC therapy (eg, atrial fibrillation, deep vein thrombosis, pulmonary thromboembolism); Bleeding diathesis, thrombocytopenia (platelet <100,000/mL) or hemoglobin <10 g/dL, and CRUSADE score-based high bleeding risk Hepatic dysfunction (serum liver enzyme>3 times the normal limit) Renal failure (eGFR <15 ml/min/1.73m2 or requiring dialysis) Severe chronic obstructive pulmonary disease Severe bradycardia (sick sinus syndrome or high degree atrioventricular block without pacemaker protection) Drugs interfering with CYP3A4 metabolism (to avoid interaction with ticagrelor): ketoconazole, itraconazole, voriconazole, clarithromycin, nefazodone, ritonavir, saquinavir, nelfinavir, indinavir, atazanavir, and telithromycin Life expectancy < 1 year
Sites / Locations
- Affiliated Hospital of Zunyi Medical UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Guided NOAC and DAPT
Unguided DAPT
The first month: rivaroxaban 2.5 mg twice daily (if CR≥24) plus standard DAPT (ticagrelor 90 mg twice daily or clopidogrel 75 mg daily plus aspirin 100 mg daily). The following 11 months: lower-dose ticagrelor 60 mg twice daily (45 mg twice daily if <50 kg, ≥75 yrs) or clopidogrel (75 mg daily) plus aspirin (100 mg daily).
The first month: standard DAPT. The following 11 months: lower-dose ticagrelor or clopidogrel plus aspirin.