{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T23:09:00Z","timestamp":1790636940171,"version":"4.1.0"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"22","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,11,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Managing large coronary thrombus burden (LCTB) in patients with ST\u2010segment\u2013elevation myocardial infarction (STEMI) remains challenging. Although deferred stenting emerged to potentially improve outcomes in this high\u2010risk population, the optimal antithrombotic regimen remains unclear. The ARISE\u2010ARMYDA 7 (Alternative Anti\u2010Thrombotic Pathways in Acute Myocardial Infarction\u2013Antiplatelet Therapy for Reduction of Myocardial Damage 7) trial evaluated low\u2010dose rivaroxaban in addition to dual antiplatelet therapy for LCTB reduction in patients with STEMI managed with deferred stenting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This single\u2010center, randomized, pilot study included patients with STEMI with angiographic evidence of LCTB undergoing primary percutaneous coronary intervention and deferred stenting. Patients were randomized to rivaroxaban 2.5 mg BID plus aspirin and ticagrelor or aspirin plus ticagrelor alone. Thrombus burden was assessed by optical coherence tomography at baseline and after 5 to 7\u2009days of treatment. The primary end point was reduction of thrombus score after this period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A total of 40 patients with STEMI and LCTB were randomized 1:1. Posttreatment thrombus score at re\u2010optical coherence tomography imaging was significantly lower in the rivaroxaban arm (39 [27\u201352] versus 82 [50\u2013111] in controls,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.005). Relative reduction of the thrombus score versus baseline was greater with rivaroxaban use (61% [50%\u201381%] versus 36% [0%\u201350%],\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.002). The relative thrombus volume decrease was 77% with rivaroxaban versus 39% in the control arm (\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.001). Deferred stenting was safe, with no abrupt vessel closures, distal embolization, or no reflow. Clinical outcomes at 30\u2009days, including major adverse cardiovascular events and bleeding complications, were not significantly different.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The ARISE\u2010ARMYDA 7 trial shows that adding low\u2010dose rivaroxaban to dual antiplatelet therapy significantly reduces thrombus burden in patients with STEMI with LCTB, while maintaining a favorable safety profile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrialsregister.eu\/ctr-search\/trial\/2020-005156-38\/IT\">https:\/\/www.clinicaltrialsregister.eu\/<\/jats:ext-link>\n                      ; Unique identifier: EudraCT 2020\u2013005156\u201038.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.041993","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:05:17Z","timestamp":1762430717000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Reduction of Thrombus Burden With Short\u2010Term, Low\u2010Dose Rivaroxaban Use in Acute Myocardial Infarction: The ARISE\u2010ARMYDA 7 Randomized Trial"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3795-8787","authenticated-orcid":false,"given":"Marco G.","family":"Mennuni","sequence":"first","affiliation":[{"name":"University of Eastern Piedmont","place":["Novara, 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Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Rosso","sequence":"additional","affiliation":[{"name":"University of Eastern Piedmont","place":["Novara, Italy"]},{"name":"Maggiore della Carit\u00e0 Hospital","place":["Novara, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"De Crescenzo","sequence":"additional","affiliation":[{"name":"Maggiore della Carit\u00e0 Hospital","place":["Novara, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3774-8330","authenticated-orcid":false,"given":"Domenico","family":"D\u2019Amario","sequence":"additional","affiliation":[{"name":"University of Eastern Piedmont","place":["Novara, Italy"]},{"name":"Maggiore della Carit\u00e0 Hospital","place":["Novara, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rocco","family":"Vergallo","sequence":"additional","affiliation":[{"name":"University of 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