{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:51:42Z","timestamp":1791525102060,"version":"4.3.4"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the association between rivaroxaban combined with clopidogrel therapy and thrombotic risk, platelet activation, myocardial injury biomarkers, and clinical outcomes in patients with coronary artery ectasia (CAE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center retrospective cohort study included 158 consecutive patients with CAE diagnosed by coronary angiography between June 2023 and June 2025. Patients receiving clopidogrel alone or rivaroxaban plus clopidogrel were compared. A 1:1 nearest-neighbor propensity score matching method was applied, generating 70 matched pairs. Thrombotic risk markers, including D-dimer (D-D), thrombin-antithrombin complex (TAT), and von Willebrand factor (vWF), platelet activation parameters [ADP-induced platelet aggregation rate (ADP-PAg) and CD62P], thromboelastography parameters [maximum amplitude (MA) and reaction time (R)], and myocardial injury-related biomarkers [high-sensitivity cardiac troponin T (hs-cTnT), creatine kinase-MB (CK-MB), heart-type fatty acid-binding protein (H-FABP), and N-terminal pro-B-type natriuretic peptide (NT-proBNP)] were evaluated at baseline and 6 months. Clinical outcomes, including thrombotic-related adverse cardiovascular events and bleeding events, were recorded during 12 months of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After propensity score matching, baseline characteristics were well balanced between groups. At 6 months, patients receiving rivaroxaban plus clopidogrel showed lower levels of D-D, TAT, vWF, ADP-PAg, CD62P, MA, hs-cTnT, CK-MB, H-FABP, and NT-proBNP, as well as prolonged R values, compared with those receiving clopidogrel alone (all\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.05). During follow-up, thrombotic-related adverse cardiovascular events occurred less frequently in the combination therapy group than in the clopidogrel group (7.14% vs. 20.00%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.027). Minor bleeding events were numerically higher in the combination therapy group (17.14% vs. 10.00%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.218), while no intracranial or fatal bleeding events occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among patients with CAE, rivaroxaban combined with clopidogrel was associated with more favorable changes in coagulation activation, platelet activity, myocardial injury biomarkers, and thrombotic-related clinical outcomes compared with clopidogrel alone. These findings suggest that combined anticoagulant and antiplatelet therapy may represent a potential strategy for selected high-risk patients with CAE. Further multicenter prospective studies are required to confirm these observations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1912975","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T05:30:29Z","timestamp":1791523829000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of rivaroxaban combined with clopidogrel on thrombotic risk and myocardial injury indicators in patients with coronary artery ectasia"],"prefix":"10.3389","volume":"13","author":[{"given":"Tao","family":"Geng","sequence":"first","affiliation":[{"name":"Department of Cardiology, Cangzhou Central Hospital of Hebei Medical University","place":["Cangzhou City, Hebei Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengwei","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cangzhou Central Hospital of Hebei Medical University","place":["Cangzhou City, Hebei Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunjie","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cangzhou Central Hospital of Hebei Medical University","place":["Cangzhou City, Hebei Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoqing","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cangzhou Central Hospital of Hebei Medical University","place":["Cangzhou City, Hebei Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingxian","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cangzhou Central Hospital of Hebei Medical University","place":["Cangzhou City, Hebei Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deguang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cangzhou Central Hospital of Hebei Medical University","place":["Cangzhou City, Hebei Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Hospital of Tianjin Medical University","place":["Tianjin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cangzhou Central Hospital of Hebei Medical University","place":["Cangzhou City, Hebei Province, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cangzhou Central Hospital of Hebei Medical 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