Low-Dose Rivaroxaban to Prevent Left Ventricular Thrombosis After Anterior Myocardial Infarction: The APERITIF Randomized Clinical Trial
Primary result · LV thrombusResult — go to the resultDifference −2.9% 95% CI −8.9% to 3.2%Authors' conclusion
In this multicenter randomized clinical trial among patients with anterior STEMI, the addition of low-dose rivaroxaban to DAPT did not demonstrate a statistically significant reduction in LV thrombus formation at 1 month but did increase minor bleeding.
Study context
- Population
- Patients with anterior STEMI
- Participants
- 560 patients
- Comparison
- Dual antiplatelet therapy (DAPT) plus low-dose rivaroxaban vs DAPT alone
- DAPT plus rivaroxabann = 283
- DAPT alonen = 277reference
- Primary endpoint
- LV thrombus on contrast-enhanced CMR
- Follow-up
- 1 month
Methodological detailsmulticentre, open-label, blinded end point, nested in FRENCHIE registry, 29 centres in France
- Multicentre
- Open-label
- Blinded end point
- Nested in FRENCHIE registry
- 29 centres in France
Primary result
LV thrombus
Difference
−2.9%
95% CI −8.9% to 3.2%
P = 0.34
Events by treatment group
DAPT plus rivaroxaban vs DAPT alone
difference −2.9% (95% CI −8.9% to 3.2%); P = 0.34
As reported in the abstract
Further findings
Largest left ventricular (LV) thrombus diameter, MACE
- No difference between the 2 groups
Safety
| Outcome | DAPT plus rivaroxaban | DAPT alone | Difference (95% CI) | |
|---|---|---|---|---|
| Major bleeding (BARC ≥type 2) | 1.5% | 0.7% | 0.7% (−1.3% to 3.1%) | |
| Minor bleeding (BARC type 1) | 16.4% | 7.2% | 9.3% (3.6%–14.8%) | |
| −1001020Difference (linear scale) |
Original publication
Low-Dose Rivaroxaban to Prevent Left Ventricular Thrombosis After Anterior Myocardial Infarction: The APERITIF Randomized Clinical Trial. JAMA Cardiol. Published 1 April 2026. doi:10.
Summarised from the published abstract; every number is checked against it