History
# Registration date Revision Id
2 2021-08-08, 1400/05/17 193340
1 2020-07-30, 1399/05/09 145216
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  • Protocol summary

    Inclusion criteria: 1. All patients with the age of 18-80 admitted with acute STEMI event treated with primary percutaneous coronary intervention 2. Presence of left ventricular thrombosis, confirmed by transthoracic echocardiography 3. Signed informed consent Exclusion criteria: 1. Previous history of mechanical prosthetic heart valve 2. Candidate for coronary artery bypass graft surgery 3. Active bleeding 4. Cardiogenic shock 5. Acute kidney injury or chronic kidney disease with a GFR<30 ml/min 6.Liver failure(Child-Pugh class C) 7.Sensitivity or intolerance with rivaroxaban/warfarin
    Inclusion criteria: 1. All patients with the age of 18-80 admitted with an acute STEMI 2. Presence of left ventricular thrombosis, confirmed by transthoracic echocardiography 3. Signed informed consent Exclusion criteria: 1. Previous history of mechanical prosthetic heart valve 2. Candidate for coronary artery bypass graft surgery 3. Active bleeding 4. Cardiogenic shock 5. Acute kidney injury or chronic kidney disease with a GFR<30 ml/min 6.Liver failure(Child-Pugh class C) 7.Sensitivity or intolerance with rivaroxaban/warfarin
    معیارهای ورود: 1.کلیه ی بیماران با سن 18-80 سال که با تشخیص انفارکتوس حاد میوکارد (در طی مدت 7 روز اخیر) تحت اینترونشن اولیه ی کرونری قرار گرفته اند 2.وجود ترومبوس در حفره ی بطن چپ که از طریق اکوکاردیوگرافی ترانس توراسیک تایید شده باشد 3.امضا کردن فرم رضایت آگاهانه معیارهای خروج: 1. سابقه ی قبلی جراحی تعویض دریچه ی قلب 2.بیمارانی که کاندید انجام جراحی بای پس قلب باشند 3.خونریزی فعال 4.شوک کاردیوژنیک 5.نارسایی حاد کلیه یا نارسایی مزمن کلیه با میزان فیلتراسیون گلومرولی کمتر از 30 میلی لیتر در دقیقه 6.نارسایی کبدی (کلاس C بر اساس چایلد-پاگ) 7.حساسیت یا عدم تحمل نسبت به ریوارکسابان/وارفارین
    معیارهای ورود: 1.کلیه ی بیماران با سن 18-80 سال با تشخیص انفارکتوس حاد میوکارد 2.وجود ترومبوس در حفره ی بطن چپ که از طریق اکوکاردیوگرافی ترانس توراسیک تایید شده باشد 3.امضا کردن فرم رضایت آگاهانه معیارهای خروج: 1. سابقه ی قبلی جراحی تعویض دریچه ی قلب 2.بیمارانی که کاندید انجام جراحی بای پس قلب باشند 3.خونریزی فعال 4.شوک کاردیوژنیک 5.نارسایی حاد کلیه یا نارسایی مزمن کلیه با میزان فیلتراسیون گلومرولی کمتر از 30 میلی لیتر در دقیقه 6.نارسایی کبدی (کلاس C بر اساس چایلد-پاگ) 7.حساسیت یا عدم تحمل نسبت به ریوارکسابان/وارفارین
  • General information

    empty
    There were few cases limited to acute STEMI who have undergone PCI. Consequently we have expanded our inclusion criteria to all patients complicating with acute STEMI
    empty
    در طول مطالعه تعداد بیمارانی که با انفارکتوس حاد میوکارد و نیازمند مداخله اینترونشن میشدند، کم بود. لذا معیارهای ورود به صورت کلیه بیماران با انفارکتوس حاد میوکارد تغییر یافت
    All patients with the age of 18-80 admitted with an acute STEMI who have undergone primary percutaneous coronary intervention
    Presence of LV thrombosis, which were confirmed by transthrocic echocardiography
    Signed informed consent
    All patients with the age of 18-80 admitted with an acute STEMI
    Presence of LV thrombosis, which were confirmed by transthrocic echocardiography
    Signed informed consent
    کلیه ی بیماران با سن 18-80 سال که با تشخیص انفارکتوس حاد میوکارد که تحت اینترونشن اولیه ی کرونری قرار گرفته اند
    وجود ترومبوس در حفره ی بطن چپ که از طریق اکوکاردیوگرافی ترانس توراسیک تایید شده باشد
    فرم رضایت نامه آگاهانه ی امضا شده
    کلیه ی بیماران با سن 18-80 سال با تشخیص انفارکتوس حاد میوکارد
    وجود ترومبوس در حفره ی بطن چپ که از طریق اکوکاردیوگرافی ترانس توراسیک تایید شده باشد
    فرم رضایت نامه آگاهانه ی امضا شده
    سابقه ی قبلی جراحی تعویض دریچه ی قلب tgcd
    بیمارانی که کاندید انجام جراحی بای پس قلب باشند
    خونریزی فعال
    شوک کاردیوژنیک
    نارسایی حاد کلیه یا نارسایی مزمن کلیه با میزان فیلتراسیون گلومرولی کمتر از 30 میلی لیتر در دقیقه
    نارسایی کبدی (کلاس C بر اساس چایلد-پاگ)
    حساسیت یا عدم تحمل نسبت به ریوارکسابان/وارفارین/مهارکننده های P2Y12
    سابقه ی قبلی جراحی تعویض دریچه ی قلب
    بیمارانی که کاندید انجام جراحی بای پس قلب باشند
    خونریزی فعال
    شوک کاردیوژنیک
    نارسایی حاد کلیه یا نارسایی مزمن کلیه با میزان فیلتراسیون گلومرولی کمتر از 30 میلی لیتر در دقیقه
    نارسایی کبدی (کلاس C بر اساس چایلد-پاگ)
    حساسیت یا عدم تحمل نسبت به ریوارکسابان/وارفارین/مهارکننده های P2Y12

Protocol summary

Study aim
Comparison of the safety of rivaroxaban-based versus warfarin-based antithrombotic regimens in patients with acute ST elevation myocardial infarction left ventricular thrombosis
Design
Two parallel groups randomized trial with blinded outcome assessment
Settings and conduct
The trial will take place in hospital setting (Rajaie cardiovascular medical and research center along with Tehran heart center) on patients with acute STEMI complicated by LVT. Patients will be randomized via central web based method into two interventional groups with two different antithrombotic regimen. Treating physician and patients will not be blinded. Thrombus status (assessed via echocardiography) and bleeding complications will be evaluated after 1 and 3 months.
Participants/Inclusion and exclusion criteria
Inclusion criteria: 1. All patients with the age of 18-80 admitted with an acute STEMI 2. Presence of left ventricular thrombosis, confirmed by transthoracic echocardiography 3. Signed informed consent Exclusion criteria: 1. Previous history of mechanical prosthetic heart valve 2. Candidate for coronary artery bypass graft surgery 3. Active bleeding 4. Cardiogenic shock 5. Acute kidney injury or chronic kidney disease with a GFR<30 ml/min 6.Liver failure(Child-Pugh class C) 7.Sensitivity or intolerance with rivaroxaban/warfarin
Intervention groups
The study contains two groups: - Intervention: rivaroxaban (15 mg daily, oral) plus clopidogrel (75 mg daily, oral) plus ASA (80 mg daily, oral; only during the first 7 days) - Control: warfarin (target INR of 2.0-3.0) plus clopidogrel(75 mg daily, oral) plus ASA (80 mg daily, oral; only during the first 7 days)
Main outcome variables
LVT resolution; LVT size; thromboembolic events; all-cause death; bleeding

General information

Reason for update
There were few cases limited to acute STEMI who have undergone PCI. Consequently we have expanded our inclusion criteria to all patients complicating with acute STEMI
Acronym
IRCT registration information
IRCT registration number: IRCT20181022041406N4
Registration date: 2020-07-30, 1399/05/09
Registration timing: registered_while_recruiting

Last update: 2021-08-09, 1400/05/18
Update count: 1
Registration date
2020-07-30, 1399/05/09
Registrant information
Name
Parham Sadeghipour
Name of organization / entity
Rajaie Cardiovascular Medical and Research Center
Country
Iran (Islamic Republic of)
Phone
+98 21 2392 2092
Email address
psadeghipour@hotmail.com
Recruitment status
Recruitment complete
Funding source
Expected recruitment start date
2020-06-21, 1399/04/01
Expected recruitment end date
2022-06-22, 1401/04/01
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Rivaroxaban Versus Warfarin in Patients With Left Ventricular Thrombus After Acute Myocardial Infarction: A Randomized Controlled Pilot Trial
Public title
Rivaroxaban in Left Ventricular Thrombus
Purpose
Treatment
Inclusion/Exclusion criteria
Inclusion criteria:
All patients with the age of 18-80 admitted with an acute STEMI Presence of LV thrombosis, which were confirmed by transthrocic echocardiography Signed informed consent
Exclusion criteria:
Previous history of mechanical prosthetic heart valve Candidate for coronary artery bypass graft surgery Active bleeding Cardiogenic shock Acute Kidney Injury or Chronic Kidney Disease with a glomerular filtration rate <30 ml/min Liver failure (Child-Pugh class C) Sensitivity or intolerance to rivaroxaban/warfarin/P2Y12 inhibitors
Age
From 18 years old to 80 years old
Gender
Both
Phase
3
Groups that have been masked
  • Outcome assessor
  • Data analyser
  • Data and Safety Monitoring Board
Sample size
Target sample size: 50
Randomization (investigator's opinion)
Randomized
Randomization description
Randomization will be performed via permuted block randomization method. Allocation will be generated via a web based system and consequently concealment will be central using computer software. Unit of randomization will be individual patients and no stratification will be applied.
Blinding (investigator's opinion)
Single blinded
Blinding description
Blinding will be performed only for the adjudicator level and analyzer level, and patients and physicians won’t be blind in this study
Placebo
Not used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Tehran Heart Center
Street address
Tehran Heart Center, Jalal-e-Al-e-Ahmad Hwy, Northern Kargar Ave, Tehran province, Tehran, Iran
City
Tehran
Province
Tehran
Postal code
1416753955
Approval date
2020-06-08, 1399/03/19
Ethics committee reference number
IR.TUMS.THC.REC.1399.004

Health conditions studied

1

Description of health condition studied
Pre-acute ST-segment Elevation Myocardial Infarction (STEMI) Left Ventricular (LV) thrombosis
ICD-10 code
I23.6
ICD-10 code description
Thrombosis of atrium, auricular appendage, and ventricle as current complications following acute myocardial infarction

Primary outcomes

1

Description
Resolution of left ventricular thrombus
Timepoint
3 months after initiation of antithrombotic therapeutic regimen
Method of measurement
Transthoracic echocardiography

Secondary outcomes

1

Description
Bleeding after initiation of antithrombotic regimen
Timepoint
1 month and 3 months after initiation of antithrombotic regimen
Method of measurement
ISTH criteria

Intervention groups

1

Description
Intervention group: Rivaroxaban-based antithrombotic therapeutic regimen
Category
Treatment - Drugs

2

Description
Control group: Warfarin-based antithrombotic therapeutic regimen
Category
Treatment - Drugs

Recruitment centers

1

Recruitment center
Name of recruitment center
Rajaie cardiovascular medical and research center
Full name of responsible person
Parham Sadeghipour
Street address
Vali-Asr ave, Hashemi Rafsanjani Exp
City
Tehran
Province
Tehran
Postal code
1995614331
Phone
+98 21 2392 2092
Email
psadeghipour@rhc.ac.ir

2

Recruitment center
Name of recruitment center
Tehran Heart Center
Full name of responsible person
Yaser Jenab
Street address
North Kargar Ave
City
Tehran
Province
Tehran
Postal code
1313814117
Phone
+98 21 8802 9600
Email
yasjenab@gmail.com

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Rajaie cardiovascular medical and research center
Full name of responsible person
Feridoun noohi
Street address
Vali-Asr Ave, Hashemi Rafsanjani Exp
City
Tehran
Province
Tehran
Postal code
1995614331
Phone
+98 21 2392 2020
Email
fnoohi@yahoo.com
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Rajaie cardiovascular medical and research center
Proportion provided by this source
100
Public or private sector
Public
Domestic or foreign origin
Domestic
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
Academic

Person responsible for general inquiries

Contact
Name of organization / entity
Rajaie Cardiovascular Medical and Research Center
Full name of responsible person
Parham Sadeghipour
Position
Associated Professor
Latest degree
Subspecialist
Other areas of specialty/work
Cardiology
Street address
Vali-Asr Ave, Hashemi Rafsanjani Exp
City
Tehran
Province
Tehran
Postal code
1995614331
Phone
+98 21 2392 2092
Fax
Email
psadeghipour@hotmail.com

Person responsible for scientific inquiries

Contact
Name of organization / entity
Rajaie cardiovascular medical and research center
Full name of responsible person
Parham Sadeghipour
Position
Associate professor
Latest degree
Subspecialist
Other areas of specialty/work
Cardiology
Street address
Vali-Asr Ave, Hashemi Rafsanjani Exp
City
Tehran
Province
Tehran
Postal code
1995614331
Phone
+98 21 2392 2092
Email
psadeghipour@hotmail.com

Person responsible for updating data

Contact
Name of organization / entity
Rajaie cardiovascular medical and research center
Full name of responsible person
Parham Sadeghipour
Position
Associate professor
Latest degree
Subspecialist
Other areas of specialty/work
Cardiology
Street address
Vali-Asr Ave, Hashemi Rafsanjani Exp
City
Tehran
Province
Tehran
Postal code
1995614331
Phone
+98 21 2392 2092
Email
psadeghipour@hotmail.com

Sharing plan

Deidentified Individual Participant Data Set (IPD)
Undecided - It is not yet known if there will be a plan to make this available
Study Protocol
Undecided - It is not yet known if there will be a plan to make this available
Statistical Analysis Plan
Undecided - It is not yet known if there will be a plan to make this available
Informed Consent Form
Undecided - It is not yet known if there will be a plan to make this available
Clinical Study Report
Undecided - It is not yet known if there will be a plan to make this available
Analytic Code
Undecided - It is not yet known if there will be a plan to make this available
Data Dictionary
Undecided - It is not yet known if there will be a plan to make this available
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