Randomized Trialhigh evidence
Milvexian with Antiplatelet Therapy after Acute Coronary Syndrome Event.
The New England journal of medicine·August 29, 2026·PMID 42670965
Why it mattersFactor XIa inhibition has been a promising strategy to reduce thrombotic events without increasing bleeding, but this large trial shows no benefit of milvexian in the acute post-ACS setting. The neutral efficacy and safety profile helps define the role of this drug class in secondary prevention and may redirect attention to other antithrombotic approaches.
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