Apixaban versus warfarin for left ventricular clot after a heart attack

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This multicenter, randomized phase 4 study enrolls adults who develop a left ventricular thrombus within 1–28 days after an acute myocardial infarction. Participants are randomly assigned to receive apixaban or warfarin and are followed with transthoracic echocardiography to document thrombus resolution. Key exclusions include patients already requiring anticoagulation for other conditions or those with high bleeding risk, severe anemia, or thrombocytopenia. The trial measures thrombus resolution as the primary outcome and records bleeding and other safety events as secondary outcomes.

Why it matters

Who can join: the full rules

Inclusion Criteria:

* Age ≥ 18 years at the time of signing the informed consent
* LV thrombus confirmed on TTE\* day 1-28 after the AMI
* Signed informed consent
* Criteria applicable only for female subjects: Women of childbearing potential must provide a negative pregnancy test not be breastfeeding and be willing and able to use highly effective contraception. Women of non-childbearing potential must be 1 year post-menopausal.

Exclusion Criteria:

* Ongoing\* treatment with anticoagulant therapy due to Mechanical heart valve prosthesis Atrial fibrillation with or without significant mitral valve stenosis Venous thromboembolism requiring anticoagulant therapy Thrombophilia requiring anticoagulant therapy Preexisting LV thrombus already treated with anticoagulant therapy Other reasons for anticoagulant therapy
* High bleeding risk Active non-trivial bleeding Known chronic bleeding disorder Severe anemia defined as hemoglobin \< 80g/L Thrombocytopenia defined as platelet count \< 80 x 10\^9
* Known significant liver disease (e.g. acute hepatitis, chronic active hepatitis, cirrhosis) or known hepatic insufficiency classified as Child-Pugh C or D at randomization
* Known allergy, intolerance or hypersensitivity to either of the study interventions
* Any contraindication for the use of an anticoagulant or listed in the local labelling for apixaban or warfarin.
* Participation in other study investigating effects and safety of anticoagulant treatment.
* Known current alcohol or drug abuse
* Any other condition, as judged by the investigator, that would make the participant unsafe or unsuitable for the study or life expectancy \< 6 months

Where it's running

• Skånes Universitetssjukhus Lund
  Lund, Sweden Recruiting
• Karolinska Insitutet
  Stockholm, Sweden Recruiting
• Karolinska Univerity Hospital
  Stockholm, Sweden Recruiting
• Falu lasarett
  Falun, Sweden Not yet recruiting
• Sahlgrenska University hospital, Mölndal
  Gothenburg, Sweden Not yet recruiting
• Sahlgrenska University hospital, Östra
  Gothenburg, Sweden Not yet recruiting

Study contacts

• Principal investigator: Moa Simonsson, MD, PhD — Department of Medicine Solna, Karolinska Institutet
• Study coordinator: Eva Olofsson
• Email: moa.simonsson@ki.se
• Phone: +46707780897

Similar studies

Other studies for the same condition or treatment. Recruiting studies are listed first.

• Evaluating a noninvasive tissue sensor to detect cardiogenic shock earlier in heart patients

  This pilot, noninvasive study tests whether the NIRSense wearable can help detect deterioration in adults with cardiogenic shock risk due to heart attack or heart failure.

  Recruiting NIRSense Inc. · Weston, Florida · NCT07825363

• Apixaban vs Warfarin for a Left Ventricular Thrombus

  This study tests whether apixaban can more conveniently and safely dissolve a left ventricular blood clot compared with warfarin.

  Recruiting Phase 3 University of Arizona · Tucson, Arizona · NCT07709780

• Adenosine given before primary PCI to reduce no-reflow in STEMI patients.

  See if giving intracoronary adenosine before primary PCI lowers the chance of slow flow/no-reflow in adults with STEMI.

  Recruiting at 2 sites Phase 4 National Institute of Cardiovascular Diseases, Pakistan · Karachi, Sindh and 1 other locations · NCT07536802

• Subclinical depression in people after a first heart attack (SUBDIMA25)

  This project will test how common mild depressive symptoms are in adults hospitalized for a first heart attack and whether those symptoms relate to biomarkers, heart function, and recovery over the next year.

  Recruiting Fondazione Policlinico Universitario Agostino Gemelli IRCCS · Roma, Italia · NCT07492537

• Long-term follow-up after Hearticellgram-AMI treatment

  We will follow people who got one dose of Hearticellgram-AMI after a heart attack for up to 60 months to see if the treatment stays safe.

  Recruiting Pharmicell Co., Ltd. · Seoul, Gangnam · NCT07400458

• Long-term remote ischemic preconditioning after a heart attack

  This trial will test whether daily brief arm blood‑flow restriction after a recent heart attack can lower the chance of major heart and brain events over the following year for people treated for acute myocardial infarction.

  Recruiting Henan Institute of Cardiovascular Epidemiology · Zhengzhou, Henan · NCT07181356

How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.