Ongoing Clinical Trials for Cardiac Ventricular Thrombosis
Cardiac ventricular thrombosis involves the formation of blood clots inside the heart’s chambers, often occurring after a heart attack. Currently, there are 3 ongoing clinical trials testing different anticoagulant medications to determine the most effective and safe treatments for dissolving these dangerous blood clots and preventing complications.
Clinical trial locations
- Austria
- France
- Sweden
Study Comparing Apixaban and Warfarin for Patients with Heart Clots After a Heart Attack
This trial is designed to compare two blood-thinning medications, apixaban and warfarin, in patients who develop blood clots in the left ventricle of the heart after experiencing a heart attack.
Who can participate: Adults aged 18 or older who have a confirmed left ventricular blood clot detected within 1 to 28 days after a heart attack using imaging tests such as echocardiogram, MRI, or CT scan. Women of childbearing age must provide a negative pregnancy test, agree not to breastfeed, and use highly effective birth control during treatment and for three months afterward.
Who cannot participate: Patients with a previous history of left ventricular blood clots or those who have recently had a heart attack are excluded from this study.
What the trial involves: The main goal is to determine which medication is more effective at dissolving blood clots in the heart. Participants will be randomly assigned to receive either apixaban (2.5 mg or 5 mg tablets) or warfarin (2.5 mg tablets) taken orally for three months. The progress of blood clot resolution will be monitored using heart ultrasound, and if needed, additional imaging such as MRI or CT scans. Researchers will also carefully track any bleeding events and major cardiovascular complications throughout the study and will follow participants for up to 12 months to check for recurrence of blood clots.
Investigational drugs: Apixaban works by blocking specific proteins involved in blood clotting, while warfarin reduces clot formation by interfering with vitamin K, which is necessary for blood clotting.
Study on Dabigatran and Phenprocoumon for Treating Left Ventricular Thrombosis After Heart Attack in Patients with STEMI
This trial focuses on patients who have experienced a specific type of severe heart attack called ST-elevation myocardial infarction (STEMI) and developed blood clots in the left ventricle. The study compares two anticoagulant medications: dabigatran etexilate and phenprocoumon.
Who can participate: Adults aged 18 or older who have been diagnosed with STEMI, undergone a procedure to open blocked heart arteries (percutaneous coronary intervention), have the left anterior descending artery as the blocked vessel, and have a clinical risk score for left ventricular blood clots greater than 2 points. Participants must have adequate kidney function (eGFR greater than 30 ml/min/1.73m²) and provide written informed consent.
Who cannot participate: Patients with a history of allergic reactions to the study medications, severe kidney problems, active bleeding disorders, those who are pregnant or breastfeeding, recent major surgery recipients, uncontrolled high blood pressure, history of stroke or heart attack in the last 6 months, or those currently participating in another clinical trial.
What the trial involves: The study aims to estimate how many patients experience resolution of blood clots and whether new silent brain strokes occur after three months of treatment. Participants will take either dabigatran (110 mg or 150 mg capsules) or phenprocoumon (tablets) orally. After three months, evaluation includes screening MRI to detect any symptomless brain strokes, followed by a twelve-month follow-up period to monitor for brain strokes and bleeding events.
Investigational drugs: Dabigatran inhibits a specific protein called thrombin that is involved in clot formation, helping prevent new clots and stopping existing ones from enlarging. Phenprocoumon is a blood thinner that reduces the blood’s ability to clot, helping to lower the risk of complications after a heart attack.
Study on Rivaroxaban, Dabigatran Etexilate, and Fluindione for Patients with Intra-Cardiac Thrombus
This trial evaluates multiple anticoagulant medications for treating blood clots that form inside any of the four chambers of the heart, comparing newer direct oral anticoagulants with traditional vitamin K antagonists.
Who can participate: Adults aged 18 or older of any gender or ethnic background who have a blood clot inside the heart (not related to medical devices) diagnosed through imaging tests such as echocardiography, cardiac CT scan, or cardiac MRI. Patients must not have taken any anticoagulant medication for at least three months before joining the study, must be enrolled in a health insurance program, and must sign an informed consent form.
Who cannot participate: Patients with device-related blood clots in the heart, those outside the specified age range, or individuals belonging to vulnerable populations requiring special protection.
What the trial involves: The study compares the effectiveness of direct oral anticoagulants (rivaroxaban, dabigatran etexilate, apixaban) against vitamin K antagonists (fluindione, warfarin, acenocoumarol) over a six-month treatment period. Participants will be randomly assigned to receive one type of medication, all taken orally. The main goal is to evaluate the net clinical benefit, including death from any cause, heart attack, stroke, embolic events, persistence of blood clots, and significant bleeding. Follow-up assessments occur at 6 and 12 months to monitor clot regression, recurrence, and safety. The study is expected to conclude by November 2026.
Investigational drugs: Direct oral anticoagulants work by directly inhibiting specific factors in the blood clotting process, making them effective in reducing stroke and clot-related complications. Vitamin K antagonists reduce the action of vitamin K, which is necessary for blood clotting, and have been a standard treatment for many years.
Summary
The three ongoing clinical trials for cardiac ventricular thrombosis are taking place in Sweden, Austria, and France, reflecting European interest in optimizing anticoagulation therapy for this serious condition. All trials focus on comparing different anticoagulant medications to determine the safest and most effective treatment options for dissolving blood clots inside the heart.
A notable pattern is the emphasis on comparing newer direct oral anticoagulants, such as apixaban, dabigatran, and rivaroxaban, against traditional vitamin K antagonists like warfarin, phenprocoumon, and fluindione. This reflects the medical community’s interest in determining whether newer medications offer advantages over established treatments in terms of effectiveness and safety, particularly regarding bleeding risk.
The trials vary in their specific patient populations, with some focusing on blood clots occurring specifically after certain types of heart attacks (STEMI), while others include any patient with blood clots inside the heart chambers. Treatment durations range from three to six months, with follow-up periods extending up to one year to monitor for complications and recurrence. These studies aim to provide evidence-based guidance for physicians treating this potentially life-threatening condition.