Inclusion Criteria:  Participant age ≥ 65years or >45 years and an additional risk factor (smoking, diabetes mellitus, hypertension, dyslipidemia or known atherosclerotic disease) Rise in troponin level, with one troponin value above the 99th percentile of the upper limit of normal deemed to be due to a type 2 myocardial infarction by the attending team within the past 30 days Alive at the time of hospital discharge  Exclusion Criteria:  Current use of anticoagulation Current use of dual antiplatelet therapy Advanced kidney disease (eGFR <15ml/min) Previous hemorrhagic stroke at any time or embolic stroke within the past year Previous life-threatening bleeding event Life expectancy less than one year Anticoagulation recommended conditions - atrial fibrillation, pulmonary embolism, deep vein thrombosis, mechanical heart valves, rheumatic mitral valve disease, left ventricular thrombosis Surgery in the previous 30 days Inability to provide informed consent in English Pregnancy, breastfeeding or child bearing potential