August 31, 2026 · The New England journal of medicine · DOI: 10.1056/NEJMoa2608717

Milvexian with Antiplatelet Therapy after Acute Coronary Syndrome Event

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This study aimed to evaluate the efficacy and safety of milvexian, an oral factor XIa inhibitor, when added to standard antiplatelet therapy in patients within 7 days of an acute coronary syndrome event. The trial found that milvexian did not significantly reduce the risk of cardiovascular death, myocardial infarction, or ischemic stroke compared to placebo, and it did not increase the risk of serious bleeding events. Consequently, the trial was terminated for futility after an interim analysis.

C Michael Gibson, P Gabriel Steg, M Cecilia Bahit, Rasha Al-Lamee, Shamir R Mehta, Roxana Mehran, Jeffrey I Weitz, Shinya Goto, Jose Carlos Nicolau, Renato D Lopes, Junbo Ge, Nebojsa Tasic, Dominick J Angiolillo, Suzanne J Baron, Ajay J Kirtane, Denis Xavier, Satoshi Yasuda, Basil S Lewis, Duk-Woo Park, Jan H Cornel, Thomas W Johnson, Jaroslaw Trebacz, Daniel Duerschmied, Christoph Bode, Bela Merkely, Maria Dorobantu, Dragos Vinereanu, Zuzana Motovska, Hector Bueno, Jose Luis Lopez-Sendon, Gregory Ducrocq, Giuseppe Ambrosio, Lesley Burgess, Allan Bohm, Chern-En Chiang, Joao Morais, Alan Fong, Umit Guray, Jose Luis Leiva-Pons, Pascal Vranckx, Harvey D White, Sasko Kedev, Marco Valgimigli, Duško Cerovec, Dimitris Tousoulis, Gemma Figtree, Thuong Dung Ho, Rody G Sy, Morten Bøttcher, Kurt Huber, Rimvydas Slapikas, Andrejs Erglis, Jack Wei Chieh Tan, Christian Pincetti, Karen S Pieper, Kenneth W Mahaffey, Carolyn S P Lam, S Claiborne Johnston, Graeme J Hankey, Luke Zheng, Ronald Aronson, Danshi Li, Ravi Notani, Philippe Vieira Pires, Thomas J Povsic, Alistair C Lindsay, Alexei Plotnikov, Hsiaowei Deng, Elliot S Barnathan, Robert A Harrington, LIBREXIA ACS Committees and Investigators

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Milvexian with Antiplatelet Therapy after Acute Coronary Syndrome Event

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