The objective of this randomized controlled trial is to compare the safety and efficacy of low dose Apixaban (2.5 mg bid) in addition to guideline directed medical therapy vs guideline directed medical therapy alone in the prevention of left ventricular thrombus formation (after 30-days) following primary PCI in patients with acute anterior myocardial infarction with severe LV dysfunction.
Patients aged 18-65 years
Presenting with acute anterior STEMI
Severe LV dysfunction (EF<35%) with antero-apical akinesis, dyskinesis, or aneurysm
WIHTOUT evidence of LV thrombus.
Patients with previous anterior myocardial infarction or LAD revascularization procedures
Patients with cardiogenic shock
Patients with LV thrombus
Patients with advanced CKD (Cr > 2 and those on hemodialysis)