Low-dose rivaroxaban could prevent LVT formation in anterior STEMI patients after PCI: JACC

Written By : Medha Baranwal |Medically Reviewed By : Dr. Kamal Kant Kohli Published On 2022-04-11T09:00:09+05:30 | Updated On 18 Oct 2023 5:04 PM IST

China: Results from a recent study support the short-duration addition of low-dose rivaroxaban to DAPT for preventing left ventricular thrombus (LVT) formation in anterior STEMI patients after percutaneous coronary intervention (PCI). The study appears in the journal JACC: Cardiovascular Interventions.

Anterior ST-elevation myocardial infarction (STEMI) is tied to an increased risk of left ventricular thrombus formation. However, there is no clarity on the contemporary role of prophylactic rivaroxaban therapy. Considering this, Zhongfan Zhang, Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China, and colleagues aimed to investigate the effects of rivaroxaban on the left ventricle thromboprophylaxis in patients with anterior STEMI.

For this purpose, the researchers included 279 patients with anterior STEMI who had undergone primary PCI. They were randomly assigned in the ratio of 1:1 to receive low-dose rivaroxaban (2.5 mg twice daily for 30 days) and dual antiplatelet therapy (DAPT) or only DAPT.

LVT formation within 30 days was the primary efficacy outcome. Assessment of net clinical adverse events was done at 30 days and 180 days, including all-cause mortality, LVT, systemic embolism, rehospitalization for cardiovascular events, and bleeding.

Following were the key findings of the study:

The addition of low-dose rivaroxaban to DAPT reduced LVT formation within 30 days compared with only DAPT (0.7% vs 8.6%; HR: 0.08).
Net clinical adverse events were lower within 30 days in the rivaroxaban group versus those in the only DAPT group and remained relatively low throughout the follow-up period.
There were no significant differences in bleeding events between the 2 groups in 30 days and 180 days. However, 1 case of intracranial hemorrhage (major bleeding) occurred in the rivaroxaban group within 30 days.

"Short-duration addition of low-dose rivaroxaban to DAPT could prevent LVT formation in patients with anterior STEMI following primary PCI," wrote the authors. "However, there is a need for a larger multiple-institution study to determine the generalizability."

Reference:

The study titled, "Prophylactic Rivaroxaban Therapy for Left Ventricular Thrombus After Anterior ST-Segment Elevation Myocardial Infarction," was published in the journal JACC: Cardiovascular Interventions.

KEYWORDS: JACC, rivaroxaban, DAPT, STEMI, dual antiplatelet therapy, left ventricular thrombus, ST-elevation myocardial infarction, Zhongfan Zhang, anterior STEMI, percutaneous coronary intervention, cardiovascular disease, bleeding

Source : JACC: Cardiovascular Interventions

Medha Baranwal

MSc. Biotechnology

Medha Baranwal joined Medical Dialogues as an Editor in 2018 for Speciality Medical Dialogues. She covers several medical specialties including Cardiac Sciences, Dentistry, Diabetes and Endo, Diagnostics, ENT, Gastroenterology, Neurosciences, and Radiology. She has completed her Bachelors in Biomedical Sciences from DU and then pursued Masters in Biotechnology from Amity University. She has a working experience of 5 years in the field of medical research writing, scientific writing, content writing, and content management. She can be contacted at editorial@medicaldialogues.in. Contact no. 011-43720751

Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751