<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03232398</url>
  </required_header>
  <id_info>
    <org_study_id>Hadassah 0607-16</org_study_id>
    <nct_id>NCT03232398</nct_id>
  </id_info>
  <brief_title>Apixaban Versus Warfarin in Patients With Left Ventricular (LV) Thrombus</brief_title>
  <official_title>Apixaban Versus Warfarin in Patients With Left Ventricular (LV) Thrombus</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Hadassah Medical Organization</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Hadassah Medical Organization</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      Patients with acute ST-segment elevation myocardial infarction (STEMI) have an elevated risk&#xD;
      of stroke, most of which are cardio-embolic in origin as a result of left ventricular (LV)&#xD;
      thrombus formation. Anterior-wall location of a MI, in particular, can lead to the&#xD;
      complications of LV aneurysm and/or thrombus, which some estimate occurs in approximately up&#xD;
      to one-third of individuals within the first 2 weeks following an anterior MI.&#xD;
&#xD;
      In the absence of anti coagulation, the risk of embolization in patients with a documented LV&#xD;
      thrombus has been reported to be between 10 and 15 percent [3]. Although there are no&#xD;
      randomized trials evaluating the efficacy of anticoagulation in patients with an LV thrombus&#xD;
      after MI, observational studies provide substantial supporting evidence for the&#xD;
      recommendation to anticoagulate patients with documented LV thrombus in order to reduce the&#xD;
      risk of embolization. The observation that most events occur within the first three months&#xD;
      from the MI forms the basis for the recommendation that anticoagulant therapy should be&#xD;
      started early and continued for at least three to six months after myocardial infarction.&#xD;
      Currently the practice guidelines recommend anticoagulation after MI only in certain settings&#xD;
      such as the presence of LV thrombus or atrial fibrillation. To date there are no data on the&#xD;
      use of novel oral anticoagulants (NOACS) for stroke prevention in the setting of LV thrombus&#xD;
      after acute MI.&#xD;
&#xD;
      The proposed aim of this randomized open label non inferiority clinical trial is to assess&#xD;
      whether apixaban is as effective as VKA for the treatment of LV thrombus after acute ST&#xD;
      segment elevation MI.&#xD;
&#xD;
      Population: Patients with evidence of LV thrombus as assessed by trans-thoracic&#xD;
      echocardiography (TTE) 3 to 7 days post admission for acute ST-elevation MI&#xD;
&#xD;
      Intervention: The patients will be randomly assigned to treatment with apixaban or s.c&#xD;
      enoxaparin 1mg/Kg BID followed by dose-adjusted warfarin to achieve a target international&#xD;
      normalized ratio (INR) of 2.0 to 3.0 for 3 months.&#xD;
&#xD;
      The study Outcomes are the presence of LV thrombus as assessed be echo, major bleeding, and&#xD;
      stroke or systemic embolism and death from any cause.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      Background and Study Rationale:&#xD;
&#xD;
      Patients with acute ST-segment elevation myocardial infarction (STEMI) have an elevated risk&#xD;
      of stroke, most of which are cardio-embolic in origin as a result of left ventricular (LV)&#xD;
      thrombus formation. The risk for stroke after myocardial infarction (MI) is estimated to be&#xD;
      44-fold higher within the first 30 days, and remains 2 to 3 times higher than expected during&#xD;
      the subsequent 3 years. Anterior-wall location of a MI, in particular, can lead to the&#xD;
      complications of LV aneurysm and/or thrombus, which some estimate occurs in approximately up&#xD;
      to one-third of individuals within the first 2 weeks following an anterior MI [2].&#xD;
&#xD;
      In the absence of anti coagulation, the risk of embolization in patients with a documented LV&#xD;
      thrombus has been reported to be between 10 and 15 percent. Although there are no randomized&#xD;
      trials evaluating the efficacy of anti coagulation in patients with an LV thrombus after MI,&#xD;
      observational studies provide substantial supporting evidence for the recommendation to anti&#xD;
      coagulate patients with documented LV thrombus in order to reduce the risk of embolization.&#xD;
      The observation that most events occur within the first three months from the MI forms the&#xD;
      basis for the recommendation that anticoagulant therapy should be started early and continued&#xD;
      for at least three to six months after myocardial infarction.&#xD;
&#xD;
      Treatment of myocardial infarction has evolved dramatically in the past 20 years, and the&#xD;
      vast majorities of patients undergo early coronary intervention and receive dual anti&#xD;
      platelet therapy (DAPT). As a result, anterior MI alone does not warrant anti coagulation&#xD;
      without evidence of LV thrombus since the combination of oral anti coagulation with DAPT&#xD;
      carries an increased risk of bleeding. Practice guidelines recommend anti coagulation after&#xD;
      MI only in certain settings such as the presence of LV thrombus or atrial fibrillation [5].&#xD;
&#xD;
      Recently oral thrombin inhibitors and factor Xa inhibitors (terms as novel oral&#xD;
      anticoagulants - NOACS) have been introduced for stroke prevention in patients with&#xD;
      non-valvular atrial fibrillation [6-8]. These agents were shown to be at least as effective&#xD;
      as Vitamin K antagonists (VKA) such as warfarin in prevention of systemic embolism, while&#xD;
      having an improved safety profile with less risk of bleeding.&#xD;
&#xD;
      To date there are no data on the use of NOACS for stroke prevention in the setting of LV&#xD;
      thrombus after acute MI. Consequently, the effectiveness and safety of anti coagulation&#xD;
      therapy with these novel agents in patients with LV thrombus warrants further investigation.&#xD;
      The devastating impact of a stroke after an MI on morbidity and mortality, and the increasing&#xD;
      number of patients at risk because of improved post-MI survival, making the goal of&#xD;
      prevention of post MI stroke a major public health concern. The proposed study aims to&#xD;
      address this important clinical topic.&#xD;
&#xD;
      Objective:&#xD;
&#xD;
      To assess whether apixaban is as effective as VKA for the treatment of LV thrombus after&#xD;
      acute ST segment elevation MI.&#xD;
&#xD;
      Design Randomized open label non inferiority clinical trial.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">January 1, 2018</start_date>
  <completion_date type="Actual">May 31, 2021</completion_date>
  <primary_completion_date type="Actual">March 31, 2021</primary_completion_date>
  <phase>Phase 3</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Randomized</allocation>
    <intervention_model>Parallel Assignment</intervention_model>
    <primary_purpose>Treatment</primary_purpose>
    <masking>Single (Outcomes Assessor)</masking>
    <masking_description>The primary efficacy endpoint will be the presence of LV thrombus as assessed be echocardiography after 3 months of treatment. Echocardiography images will be reviewed for the presence of LV thrombus by two experts who will be blinded to the study drug.</masking_description>
  </study_design_info>
  <primary_outcome>
    <measure>Presence and dimensions of Left ventricular thrombus (LV) as assessed by 2D echocardiography</measure>
    <time_frame>3 months</time_frame>
    <description>The primary efficacy endpoint will be the presence of LV thrombus as assessed be echocardiography after 3 months of treatment with oral anti coagulation. Dimensions of the LV thrombus (if still present) will be compared to the thrombus dimensions at baseline.</description>
  </primary_outcome>
  <secondary_outcome>
    <measure>Stroke or systemic embolism</measure>
    <time_frame>3 months</time_frame>
    <description>Clinically significant stroke or systemic embolism requiring hospitalization</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>Major bleeding</measure>
    <time_frame>3 months</time_frame>
    <description>Major bleeding, according to the criteria of the International Society on Thrombosis and Haemostasis (ISTH)</description>
  </secondary_outcome>
  <secondary_outcome>
    <measure>All cause mortality</measure>
    <time_frame>3 months</time_frame>
    <description>Death from any cause.</description>
  </secondary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">40</enrollment>
  <condition>Acute Myocardial Infarction</condition>
  <condition>Left Ventricular Thrombosis</condition>
  <condition>Anticoagulants and Bleeding Disorders</condition>
  <arm_group>
    <arm_group_label>Apixaban</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Apixaban Oral Tablet [Eliquis]</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Warfarin</arm_group_label>
    <arm_group_type>Active Comparator</arm_group_type>
    <description>Warfarin - Vitamin K antagonist</description>
  </arm_group>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Apixaban Oral Tablet [Eliquis]</intervention_name>
    <description>Apixaban 5 mg BID for 3 months. Apixaban 2.5-mg BID doses will be used in a subset of patients with two or more of the following criteria: an age of at least 80 years, a body weight of no more than 60 kg, or a serum creatinine level of 1.5 mg per deciliter (133 μmol per liter) or more. Patients with advanced renal failure (CrCl between 15 ml/min and 29 mi/min) will also receive 2.5 mg BID.</description>
    <arm_group_label>Apixaban</arm_group_label>
    <arm_group_label>Warfarin</arm_group_label>
    <other_name>Eliquis</other_name>
  </intervention>
  <intervention>
    <intervention_type>Drug</intervention_type>
    <intervention_name>Warfarin</intervention_name>
    <description>Dose-adjusted warfarin to achieve a target international normalized ratio (INR) of 2.0 to 3.0 for 3 months</description>
    <arm_group_label>Apixaban</arm_group_label>
    <arm_group_label>Warfarin</arm_group_label>
    <other_name>Coumadin</other_name>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
          -  Patients with evidence of LV thrombus as assessed by trans-thoracic echocardiography&#xD;
&#xD;
          -  Acute MI in last 3 months prior to enrollment&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          -  Patients with contraindications for chronic anti coagulation&#xD;
&#xD;
          -  Patients with severe renal failure (CrCl&lt; 15 ml/min)&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>100 Years</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <overall_official>
    <last_name>Ronny Alcalai</last_name>
    <role>Principal Investigator</role>
    <affiliation>Hadassah Medical Organization</affiliation>
  </overall_official>
  <location>
    <facility>
      <name>Hadassah Medical Organization</name>
      <address>
        <city>Jerusalem</city>
        <country>Israel</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Israel</country>
  </location_countries>
  <reference>
    <citation>Witt BJ, Brown RD Jr, Jacobsen SJ, Weston SA, Yawn BP, Roger VL. A community-based study of stroke incidence after myocardial infarction. Ann Intern Med. 2005 Dec 6;143(11):785-92. doi: 10.7326/0003-4819-143-11-200512060-00006.</citation>
    <PMID>16330789</PMID>
  </reference>
  <reference>
    <citation>Fuster V, Halperin JL. Left ventricular thrombi and cerebral embolism. N Engl J Med. 1989 Feb 9;320(6):392-4. doi: 10.1056/NEJM198902093200610. No abstract available.</citation>
    <PMID>2913497</PMID>
  </reference>
  <reference>
    <citation>Vaitkus PT, Barnathan ES. Embolic potential, prevention and management of mural thrombus complicating anterior myocardial infarction: a meta-analysis. J Am Coll Cardiol. 1993 Oct;22(4):1004-9. doi: 10.1016/0735-1097(93)90409-t.</citation>
    <PMID>8409034</PMID>
  </reference>
  <reference>
    <citation>Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, Al-Khalidi HR, Ansell J, Atar D, Avezum A, Bahit MC, Diaz R, Easton JD, Ezekowitz JA, Flaker G, Garcia D, Geraldes M, Gersh BJ, Golitsyn S, Goto S, Hermosillo AG, Hohnloser SH, Horowitz J, Mohan P, Jansky P, Lewis BS, Lopez-Sendon JL, Pais P, Parkhomenko A, Verheugt FW, Zhu J, Wallentin L; ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011 Sep 15;365(11):981-92. doi: 10.1056/NEJMoa1107039. Epub 2011 Aug 27.</citation>
    <PMID>21870978</PMID>
  </reference>
  <reference>
    <citation>Schulman S, Kearon C; Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost. 2005 Apr;3(4):692-4. doi: 10.1111/j.1538-7836.2005.01204.x.</citation>
    <PMID>15842354</PMID>
  </reference>
  <verification_date>August 2021</verification_date>
  <study_first_submitted>July 16, 2017</study_first_submitted>
  <study_first_submitted_qc>July 25, 2017</study_first_submitted_qc>
  <study_first_posted type="Actual">July 28, 2017</study_first_posted>
  <last_update_submitted>August 24, 2021</last_update_submitted>
  <last_update_submitted_qc>August 24, 2021</last_update_submitted_qc>
  <last_update_posted type="Actual">August 25, 2021</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Hadassah Medical Organization</investigator_affiliation>
    <investigator_full_name>RONNY ALCALAI</investigator_full_name>
    <investigator_title>Director, Cardiac Care Unit</investigator_title>
  </responsible_party>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Myocardial Infarction</mesh_term>
    <mesh_term>Thrombosis</mesh_term>
    <mesh_term>Hemostatic Disorders</mesh_term>
    <mesh_term>Blood Coagulation Disorders</mesh_term>
    <mesh_term>Infarction</mesh_term>
  </condition_browse>
  <intervention_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Warfarin</mesh_term>
    <mesh_term>Apixaban</mesh_term>
  </intervention_browse>
  <patient_data>
    <sharing_ipd>No</sharing_ipd>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03232398
org study id: Hadassah 0607-16
nct id: NCT03232398
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
Patients with acute ST-segment elevation myocardial infarction (STEMI) have an elevated risk
      of stroke, most of which are cardio-embolic in origin as a result of left ventricular (LV)
      thrombus formation. Anterior-wall location of a MI, in particular, can lead to the
      complications of LV aneurysm and/or thrombus, which some estimate occurs in approximately up
      to one-third of individuals within the first 2 weeks following an anterior MI.

      In the absence of anti coagulation, the risk of embolization in patients with a documented LV
      thrombus has been reported to be between 10 and 15 percent [3]. Although there are no
      randomized trials evaluating the efficacy of anticoagulation in patients with an LV thrombus
      after MI, observational studies provide substantial supporting evidence for the
      recommendation to anticoagulate patients with documented LV thrombus in order to reduce the
      risk of embolization. The observation that most events occur within the first three months
      from the MI forms the basis for the recommendation that anticoagulant therapy should be
      started early and continued for at least three to six months after myocardial infarction.
      Currently the practice guidelines recommend anticoagulation after MI only in certain settings
      such as the presence of LV thrombus or atrial fibrillation. To date there are no data on the
      use of novel oral anticoagulants (NOACS) for stroke prevention in the setting of LV thrombus
      after acute MI.

      The proposed aim of this randomized open label non inferiority clinical trial is to assess
      whether apixaban is as effective as VKA for the treatment of LV thrombus after acute ST
      segment elevation MI.

      Population: Patients with evidence of LV thrombus as assessed by trans-thoracic
      echocardiography (TTE) 3 to 7 days post admission for acute ST-elevation MI

      Intervention: The patients will be randomly assigned to treatment with apixaban or s.c
      enoxaparin 1mg/Kg BID followed by dose-adjusted warfarin to achieve a target international
      normalized ratio (INR) of 2.0 to 3.0 for 3 months.

      The study Outcomes are the presence of LV thrombus as assessed be echo, major bleeding, and
      stroke or systemic embolism and death from any cause.
Background and Study Rationale:

      Patients with acute ST-segment elevation myocardial infarction (STEMI) have an elevated risk
      of stroke, most of which are cardio-embolic in origin as a result of left ventricular (LV)
      thrombus formation. The risk for stroke after myocardial infarction (MI) is estimated to be
      44-fold higher within the first 30 days, and remains 2 to 3 times higher than expected during
      the subsequent 3 years. Anterior-wall location of a MI, in particular, can lead to the
      complications of LV aneurysm and/or thrombus, which some estimate occurs in approximately up
      to one-third of individuals within the first 2 weeks following an anterior MI [2].

      In the absence of anti coagulation, the risk of embolization in patients with a documented LV
      thrombus has been reported to be between 10 and 15 percent. Although there are no randomized
      trials evaluating the efficacy of anti coagulation in patients with an LV thrombus after MI,
      observational studies provide substantial supporting evidence for the recommendation to anti
      coagulate patients with documented LV thrombus in order to reduce the risk of embolization.
      The observation that most events occur within the first three months from the MI forms the
      basis for the recommendation that anticoagulant therapy should be started early and continued
      for at least three to six months after myocardial infarction.

      Treatment of myocardial infarction has evolved dramatically in the past 20 years, and the
      vast majorities of patients undergo early coronary intervention and receive dual anti
      platelet therapy (DAPT). As a result, anterior MI alone does not warrant anti coagulation
      without evidence of LV thrombus since the combination of oral anti coagulation with DAPT
      carries an increased risk of bleeding. Practice guidelines recommend anti coagulation after
      MI only in certain settings such as the presence of LV thrombus or atrial fibrillation [5].

      Recently oral thrombin inhibitors and factor Xa inhibitors (terms as novel oral
      anticoagulants - NOACS) have been introduced for stroke prevention in patients with
      non-valvular atrial fibrillation [6-8]. These agents were shown to be at least as effective
      as Vitamin K antagonists (VKA) such as warfarin in prevention of systemic embolism, while
      having an improved safety profile with less risk of bleeding.

      To date there are no data on the use of NOACS for stroke prevention in the setting of LV
      thrombus after acute MI. Consequently, the effectiveness and safety of anti coagulation
      therapy with these novel agents in patients with LV thrombus warrants further investigation.
      The devastating impact of a stroke after an MI on morbidity and mortality, and the increasing
      number of patients at risk because of improved post-MI survival, making the goal of
      prevention of post MI stroke a major public health concern. The proposed study aims to
      address this important clinical topic.

      Objective:

      To assess whether apixaban is as effective as VKA for the treatment of LV thrombus after
      acute ST segment elevation MI.

      Design Randomized open label non inferiority clinical trial.
allocation: Randomized
intervention model: Parallel Assignment
primary purpose: Treatment
masking: Single (Outcomes Assessor)
masking description: The primary efficacy endpoint will be the presence of LV thrombus as assessed be echocardiography after 3 months of treatment. Echocardiography images will be reviewed for the presence of LV thrombus by two experts who will be blinded to the study drug.
measure: Presence and dimensions of Left ventricular thrombus (LV) as assessed by 2D echocardiography
time frame: 3 months
description: The primary efficacy endpoint will be the presence of LV thrombus as assessed be echocardiography after 3 months of treatment with oral anti coagulation. Dimensions of the LV thrombus (if still present) will be compared to the thrombus dimensions at baseline.
measure: Stroke or systemic embolism
time frame: 3 months
description: Clinically significant stroke or systemic embolism requiring hospitalization
measure: Major bleeding
time frame: 3 months
description: Major bleeding, according to the criteria of the International Society on Thrombosis and Haemostasis (ISTH)
measure: All cause mortality
time frame: 3 months
description: Death from any cause.
arm group label: Apixaban
arm group type: Active Comparator
description: Apixaban Oral Tablet [Eliquis]
arm group label: Warfarin
arm group type: Active Comparator
description: Warfarin - Vitamin K antagonist
intervention type: Drug
intervention name: Apixaban Oral Tablet [Eliquis]
description: Apixaban 5 mg BID for 3 months. Apixaban 2.5-mg BID doses will be used in a subset of patients with two or more of the following criteria: an age of at least 80 years, a body weight of no more than 60 kg, or a serum creatinine level of 1.5 mg per deciliter (133 μmol per liter) or more. Patients with advanced renal failure (CrCl between 15 ml/min and 29 mi/min) will also receive 2.5 mg BID.
arm group label: Apixaban
arm group label: Warfarin
other name: Eliquis
intervention type: Drug
intervention name: Warfarin
description: Dose-adjusted warfarin to achieve a target international normalized ratio (INR) of 2.0 to 3.0 for 3 months
arm group label: Apixaban
arm group label: Warfarin
other name: Coumadin
criteria: 
gender: All
minimum age: 18 Years
maximum age: 100 Years
healthy volunteers: No
last name: Ronny Alcalai
role: Principal Investigator
affiliation: Hadassah Medical Organization
facility: 
country: Israel
citation: Witt BJ, Brown RD Jr, Jacobsen SJ, Weston SA, Yawn BP, Roger VL. A community-based study of stroke incidence after myocardial infarction. Ann Intern Med. 2005 Dec 6;143(11):785-92. doi: 10.7326/0003-4819-143-11-200512060-00006.
PMID: 16330789
citation: Fuster V, Halperin JL. Left ventricular thrombi and cerebral embolism. N Engl J Med. 1989 Feb 9;320(6):392-4. doi: 10.1056/NEJM198902093200610. No abstract available.
PMID: 2913497
citation: Vaitkus PT, Barnathan ES. Embolic potential, prevention and management of mural thrombus complicating anterior myocardial infarction: a meta-analysis. J Am Coll Cardiol. 1993 Oct;22(4):1004-9. doi: 10.1016/0735-1097(93)90409-t.
PMID: 8409034
citation: Granger CB, Alexander JH, McMurray JJ, Lopes RD, Hylek EM, Hanna M, Al-Khalidi HR, Ansell J, Atar D, Avezum A, Bahit MC, Diaz R, Easton JD, Ezekowitz JA, Flaker G, Garcia D, Geraldes M, Gersh BJ, Golitsyn S, Goto S, Hermosillo AG, Hohnloser SH, Horowitz J, Mohan P, Jansky P, Lewis BS, Lopez-Sendon JL, Pais P, Parkhomenko A, Verheugt FW, Zhu J, Wallentin L; ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011 Sep 15;365(11):981-92. doi: 10.1056/NEJMoa1107039. Epub 2011 Aug 27.
PMID: 21870978
citation: Schulman S, Kearon C; Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on Thrombosis and Haemostasis. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost. 2005 Apr;3(4):692-4. doi: 10.1111/j.1538-7836.2005.01204.x.
PMID: 15842354
responsible party type: Principal Investigator
investigator affiliation: Hadassah Medical Organization
investigator full name: RONNY ALCALAI
investigator title: Director, Cardiac Care Unit
mesh term: Myocardial Infarction
mesh term: Thrombosis
mesh term: Hemostatic Disorders
mesh term: Blood Coagulation Disorders
mesh term: Infarction
mesh term: Warfarin
mesh term: Apixaban
sharing ipd: No