{"id":138786,"date":"2025-04-01T11:15:17","date_gmt":"2025-04-01T15:15:17","guid":{"rendered":"https:\/\/cardiologynownews.org\/?p=138786"},"modified":"2026-01-28T19:08:04","modified_gmt":"2026-01-29T00:08:04","slug":"early-short-term-use-of-rivaroxaban-plus-dapt-significantly-reduces-intracoronary-thrombus","status":"publish","type":"post","link":"https:\/\/cardiologynownews.org\/?p=138786","title":{"rendered":"Early, Short-Term Use of Rivaroxaban Plus DAPT Significantly Reduces Intracoronary Thrombus"},"content":{"rendered":"<p><b>Key Points:\u00a0<\/b><\/p>\n<ul>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">In the ARISE-ARMYDA 7 trial, 40 patients who presented with ST elevation myocardial infarction and a plan for a deferred stenting strategy were randomized to receive rivaroxaban 2.5 mg + dual-antiplatelet therapy (DAPT) or DAPT alone to evaluate the primary endpoint of OCT-derived thrombus burden reduction after six days.<\/span><\/li>\n<li style=\"font-weight: 400;\" aria-level=\"1\"><span style=\"font-weight: 400;\">There was a significantly greater reduction in OCT-derived thrombus burden after 6 days in the rivaroxaban + DAPT group compared to the DAPT alone group.<\/span><\/li>\n<\/ul>\n<p><!--more--><\/p>\n<p><span style=\"font-weight: 400;\">Although percutaneous coronary intervention (PCI) is the preferred treatment for an ST-elevation myocardial infarction, PCI can be challenging in cases with large thrombotic burden in which there is a high risk for distal thrombus embolization. In the ARISE-ARMYDA 7, patients who presented with STEMI and a large thrombotic burden with a plan for a delayed stenting strategy were randomized to receive rivaroxaban 2.5 mg + dual-antiplatelet therapy (DAPT) including aspirin and ticagrelor or DAPT alone to evaluate the primary endpoint of OCT-derived thrombus burden reduction after six days.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">To be included in the trial, patients had to have presented with a STEMI with symptom onset within 24 hours and a plan for a deferred stenting strategy. Patients also had to have a large thrombus burden, culprit vessel \u2265 3.0 mm, and successful thrombus aspiration of balloon angioplasty restoring \u2265 TIMI 2 flow. Enrolled patients were planned to undergo OCT assessment of their thrombus score at baseline and again at 5-7 days.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The study enrolled 44 patients of which 40 underwent follow-up OCT imaging. The mean patient age was 62 years old and 12.5% of patients were female. The authors found a significantly greater reduction in thrombus burden in the rivaroxaban + DAPT group compared to the DAPT alone group with a difference in thrombus score of 66 vs 44 respectively (p=0.040). There were also reductions in two secondary endpoints \u2013 thrombus volume and thrombus area\u2014in the treatment group. Although the study was not powered for clinical endpoints, there were no major adverse cardiac events in the treatment group and only 2 minor bleeding events.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">There are several important limitations of this study. First, patients with high bleeding risk were excluded from the sample and only patients who were going to receive a delayed stenting strategy were eligible for inclusion. This represents a small, focused subset of patients within the STEMI population. In addition, because the focus was on an OCT-based primary outcome instead of clinical outcomes, it is unclear what the clinical impact of treatment with rivaroxaban 2.5 mg + DAPT would be. Finally, the small sample size further limits the generalizability of the study. In conclusion, although the treatment strategy of rivaroxaban 2.5 mg + dual-antiplatelet therapy led to a reduction in OCT-based thrombus burden at 6 days among patients with STEMI undergoing a delayed stenting strategy, the findings of this study may not be generalizable and it would be important for future studies to evaluate clinical endpoints in a larger population.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Key Points:\u00a0 In the ARISE-ARMYDA 7 trial, 40 patients who presented with ST elevation myocardial infarction and a plan for a deferred stenting strategy were randomized to receive rivaroxaban 2.5 mg + dual-antiplatelet therapy (DAPT) or DAPT alone to evaluate the primary endpoint of OCT-derived thrombus burden reduction after six days. There was a significantly [&hellip;]<\/p>\n","protected":false},"author":40620,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[898,8],"tags":[899,45,47,185],"ppma_author":[1076],"class_list":{"0":"post-138786","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-acc-2025","7":"category-news","8":"tag-acc-2025","9":"tag-conference","10":"tag-featured","11":"tag-news","12":"author-christina-lalani-md"},"authors":[{"term_id":1076,"user_id":40620,"is_guest":0,"slug":"christina-lalani-md","display_name":"Christina Lalani MD","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138786","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40620"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=138786"}],"version-history":[{"count":1,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138786\/revisions"}],"predecessor-version":[{"id":138787,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138786\/revisions\/138787"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=138786"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=138786"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=138786"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=138786"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}