Coronary disease & ACSRandomised controlled trial

Low-Dose Rivaroxaban to Prevent Left Ventricular Thrombosis After Anterior Myocardial Infarction

JAMA CardiolPublished

  • Randomised controlled trial
  • multicentre
  • open-label
  • blinded end point
  • nested in FRENCHIE registry
  • 29 centres in France

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

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

OutcomeDAPT plus rivaroxabanDAPT alonedifference (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%)

Original publication

Low-Dose Rivaroxaban to Prevent Left Ventricular Thrombosis After Anterior Myocardial Infarction. JAMA Cardiol. Published 1 April 2026. doi:10.1001/jamacardio.2026.0026

Summarised from the published abstract; every number is checked against it