LA-HCM Study : Rivaroxaban for Antithrombotic Prevention in Hypertrophic Cardiomyopathy Patients With Abnormal Left Atrial Strain.

Inclusion criteria

• 40 - 80 years of age
• 50 and 120 kg of weight
• In sinus rhythm
• Prior confirmed diagnosis of "primary" hypertrophic cardiomyopathy
• Left Atrial reservoir strain measured ≤20% (corelab confirmation)
• Signature of an informed consent
• Highly effective contraceptive methods for women of childbearing potential from at least 14 days prior to start treatment, throughout the study treatment period, and until at least 4 weeks after the last dose of study medication

Exclusion criteria

• Secondary hypertrophic cardiomyopathy (aortic stenosis, hypertension, amyloidosis and all phenocopies…)
• Signs of heart failure
• Hospitalization
• Uncontrolled blood pressure
• Creatinine clearance <30 mL/min (Cockcroft)
• Severe liver dysfunction, cirrhosis Child B or C
• Any anticoagulation therapy in the 15 days prior to enrollment
• Any cardiac surgery in the 30 days prior to enrollment
• Documented atrial arrhythmia
• Any major bleeding in the 90 days prior to enrollment
• Need to be on dual antiplatelet therapy (aspirin >100 mg daily and a P2Y12 inhibitor, i.e. clopidogrel, ticagrelor, prasugrel…).
• Contraindication for a brain magnetic resonance imaging exam
• Known hypersensitivity or others contraindications to Rivaroxaban (refer to contraindications)
• Ischemic stroke or intracranial hemorrhage in the 30 days prior to enrollment
• Active endocarditis at the time of enrollment
• Concomitant combined strong P-gp and CYP3A4 inducers or inhibitors
• Active cancer or life expectancy less than 3 years
• Non-compliant
• Participation in another interventional clinical trial
• Protected person (adults legally protected (under judicial protection, guardianship or supervision), person deprived of their liberty, pregnant woman, lactating woman or planning pregnancy during the study period and minor)
• Absence of coverage by a social security scheme