Post-Operative Biomarker-Guided Precision Medicine For Cardiovascular Risk Reduction

NCT ID: NCT06961630

Last Updated: 2025-10-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

EARLY_PHASE1

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-10-07

Study Completion Date

2027-03-31

Brief Summary

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The goal of this pilot study is to assess enrollment feasibility of a randomized trial of direct oral anticoagulant and high-intensity statin therapy versus usual care in patients with Myocardial Injury after Noncardiac Surgery (MINS). The primary aims of this study are to assess feasibility, study drug adherence, and optimize study design (entry criteria, study endpoints, sample size calculation, site selection) and recruitment strategies for the future multicenter randomized clinical trial studying biomarker-based care in post-operative patients at elevated cardiovascular (CV) risk.

Detailed Description

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Conditions

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Myocardial Injury After Noncardiac Surgery

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Rivaroxaban + Atorvastatin

Participants assigned to this arm will receive rivaroxaban 2.5mg twice daily + atorvastatin 80mg daily for 6 months.

Group Type EXPERIMENTAL

Rivaroxaban

Intervention Type DRUG

Rivaroxaban 2.5mg will be orally administered twice daily for 6 months.

Atorvastatin

Intervention Type DRUG

Atorvastatin 80mg will be orally administered daily for 6 months.

Usual Care

Participants assigned to usual care will continue all clinically indicated therapies as prescribed by their treating physicians.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Rivaroxaban

Rivaroxaban 2.5mg will be orally administered twice daily for 6 months.

Intervention Type DRUG

Atorvastatin

Atorvastatin 80mg will be orally administered daily for 6 months.

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

1. Adults ≥45 years
2. Underwent major non-cardiac surgery requiring ≥1 overnight inpatient stay in the prior 14 days
3. Myocardial injury after noncardiac surgery, defined as a post-operative troponin ≥ 99th percentile upper reference limit \[URL\], with rise/fall \>20% indicative of acute myocardial injury.
4. Ability to provide informed consent

Exclusion Criteria

1. Expected survival \<6 months
2. Hemorrhagic disorder
3. Surgeon feels it is unsafe to initiate low-dose anticoagulation within 14 days of surgery
4. Indication for oral anticoagulation at discharge
5. Indication for dual antiplatelet therapy at discharge
6. Patient already receiving or planned to receive moderate or high-intensity statin
7. Contraindication to high-intensity statin
8. Contraindication to rivaroxaban
9. End stage kidney disease on hemodialysis
10. Acute liver failure or decompensated cirrhosis
11. Pregnancy
Minimum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role collaborator

NYU Langone Health

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nathaniel R. Smilowitz, MD, MS

Role: PRINCIPAL_INVESTIGATOR

NYU Langone Health

Locations

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NYU Langone Health

New York, New York, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Nathaniel Smilowitz

Role: CONTACT

212-263-5656

Other Identifiers

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1R34HL173301-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

24-01260

Identifier Type: -

Identifier Source: org_study_id

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