Apixaban Versus Warfarin for Left Ventricular Thrombus

Conditions

• Left Ventricular Thrombus

Eligibility Criteria

Sex

ALL

Age

18 Years - N/A

Healthy Volunteers

Not accepted

Interventions

• Apixaban — DRUG
  Apixaban 5 mg orally twice daily
• Warfarin — DRUG
  Warfarin will be prescribed with dose adjustment to maintain INR 2.0-3.0.

Study Details

Left ventricular thrombus is a blood clot that forms in the left ventricle and is associated with risk of systemic embolism and ischemic stroke. Warfarin has historically been used for anticoagulation in this condition, but it requires frequent international normalized ratio monitoring and is affected by dietary and drug interactions. Apixaban is a direct oral factor Xa inhibitor with fixed dosing and no routine anticoagulation monitoring requirement, and it is increasingly used in clinical practice for left ventricular thrombus, although definitive randomized evidence remains limited. This randomized, noninferiority trial will compare apixaban with warfarin for treatment of left ventricular thrombus. Eligible adults with recently confirmed left ventricular thrombus will be randomized 1:1 to apixaban or warfarin. The primary endpoint is complete left ventricular thrombus resolution at 3 months assessed by cardiac magnetic resonance imaging. Participants will be followed through 12 months for thrombus-related, bleeding, cardiovascular, and mortality outcomes.

Key Dates

First listed

Jul 17, 2026

Start date

Jun 22, 2026

Status verified

Jun 2026

Primary completion

Jul 1, 2028

Completion

Jul 1, 2029

Study Design

Enrollment

218 participants (estimated)

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

TREATMENT

Arms

• Experimental: Apixaban
  Participants randomized to apixaban will receive oral apixaban for treatment of left ventricular thrombus according to standard clinical dosing and follow-up.
• Active Comparator: Warfarin
  Participants randomized to warfarin will receive oral dose-adjusted warfarin for treatment of left ventricular thrombus according to standard clinical care.

Primary Outcome Measure

Complete Left Ventricular Thrombus Resolution at 3 Months [ Time Frame: 3 months after randomization ]

Central Contacts

• Tushar Acharya, MD, MPH
  520-626-0968
  [email protected]

Locations (1)

Find similar trials in Tucson, AZ