REsolution of LEft VENTtricular thrombus (RELEVENT)

This trial is for patients who have been diagnosed with a blood clot forming inside the left ventricle of the heart — known as a left ventricular (LV) thrombus. This type of clot can develop after a heart attack or in people with a weakened heart, and it significantly increases the risk of stroke if it breaks off and travels to the brain. The standard treatment is warfarin, a blood thinner that requires regular monitoring. Newer blood thinners called direct oral anticoagulants (DOACs) — such as apixaban, rivaroxaban, and dabigatran — are easier to take and do not need frequent blood tests, but have not been formally approved for this specific use. This trial randomly assigns participants to receive either a DOAC or warfarin for 3 months, then uses imaging (ultrasound or MRI) to check whether the clot has dissolved. Researchers will also track strokes, major bleeding, and other cardiac events. Participants are followed for up to 3 years after treatment. You may be eligible if you have a new diagnosis of LV thrombus on any heart scan within the last 10 days. People with mechanical heart valves, severe kidney or liver disease, active bleeding or a recent brain bleed, atrial fibrillation with significant valve disease, or those who are pregnant are not eligible.