Rivaroxaban vErsus Warfarin for Antithrombotic TheRapy in Patients With LeFt Ventricular Thrombus After Acute STEMI

The purpose of the study is to assess the safety and efficacy of rivaroxaban-based versus warfarin-based antithrombotic regimens on outcomes of patients with left ventricle thrombosis following acute ST elevation myocardial infarction at 3 months from enrollment in an open-label parallel groups pilot randomized clinical trial

Inclusion criteriaAdult patients aged 18-80 yearsAdmission with acute STEMI in past 2 weeksAcute LVT confirmed by non-contrast TTEWillingness to participate and to provide a signed informed consent formExclusion criteriaHistory of the mechanical prosthetic heart valve, rheumatic heart disease, and confirmed case of antiphospholipid syndromeActive bleedingCardiogenic shock defined as persistent hypotension (systolic blood pressure <90 mm Hg, or requirement of vasopressor to maintain systolic pressure >90 mm Hg) and clinical signs of hypoperfusion (cold, sweated extremities, oliguria, mental confusion, dizziness, narrow pulse pressure)Acute kidney injury or chronic kidney disease with a glomerular filtration rate <30 ml/min (calculated based on the Cockcroft-Gault formula)Liver failure (Child-Pugh class C)Other indications for chronic anticoagulation (e.g., AF, VTE, etc.)Sensitivity or intolerance to rivaroxaban/warfarin