This study checks if a medicine called milvexian helps reduce serious heart problems after a recent heart issue, known as an acute coronary syndrome (ACS). ACS includes problems like a heart attack or severe chest pain. The study compares milvexian to a placebo, which is a pill with no active medicine, while participants also receive regular heart care.

• Participants need to have had a heart problem in the last 7 days.
• Participants should have two or more risk factors like being 65+, having diabetes, or a history of heart issues.
• Women who might have children must test negative for pregnancy and cannot be pregnant or breastfeeding.

People cannot join if: their heart attack was due to something other than ACS, they need certain heart surgeries after joining, or have a high risk of bleeding.

Joining involves taking medicine and regular follow-ups. Please consider if you meet criteria and discuss with your doctor if this study is suitable for you.

Key Points:

• Study duration and visits will be shared at sign-up.
• Participants may receive compensation.
• Consider potential risks related to bleeding.