New trial tests if adding a blood thinner to standard care prevents heart attacks in rare artery condition

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Adults aged 18 to 80 years, of either sex, hospitalized with acute coronary syndrome (ACS) with or without ST-segment elevation. * Recent ACS within 7 days prior to enrollment, defined by all of the following: * Clinical presentation consistent with acute coronary syndrome. * Elevated high-sensitivity cardiac troponin above the 99th percentile. * Presence or absence of persistent ST-segment elevation. * Coronary artery ectasia in the culprit coronary artery, defined by all of the following: * The presence of ectasia will be determined by agreement of two expert interventional cardiologists, and will be confirmed by quantitative coronary angiography (QCA). * Identification of a culprit artery consistent with the electrocardiographic territory involved (in cases with ST-segment elevation) or with angiographic features suggestive of an atherothrombotic event, such as the presence of thrombus or reduced coronary flow. * Hospital admission lasting more than 24 hours. * Management with either percutaneous coronary intervention or medical therapy, as determined by the treating medical team. Intracoronary interventions such as stent implantation, balloon angioplasty, or thrombus aspiration are permitted. * Ability and willingness to provide written informed consent and to participate in the study. Exclusion Criteria: * Pregnant women. * Current indication for temporary or long-term anticoagulation therapy at the time of enrollment. * Severe chronic kidney disease, defined as KDIGO stage G4 or higher (estimated glomerular filtration rate \[eGFR\] \<30 mL/min/1.73 m²). * Estimated glomerular filtration rate (eGFR) \<30 mL/min/1.73 m² at hospital discharge. * History of major bleeding, active bleeding, or high bleeding risk, including but not limited to gastrointestinal bleeding, intracranial hemorrhage, or other conditions considered by the treating physician to confer a high risk of bleeding. * Advanced heart failure, defined as left ventricular ejection fraction (LVEF) \<30% plus at least one of the following: * More than two hospitalizations or unplanned emergency department visits for heart failure in the past year, or * NYHA functional class III or IV symptoms despite optimal medical therapy at enrollment or within the previous 3 months.