Resolution of left atrial appendage thrombus with apixaban

Area of Science:

• Cardiology
• Pharmacology

Background:

• Left atrial appendage (LAA) thrombosis is a significant risk factor for cardiogenic cerebral thromboembolism.
• Novel oral anticoagulants (NOACs) like apixaban are increasingly used for stroke prevention in atrial fibrillation, demonstrating advantages over warfarin.

Observation:

• A 72-year-old male patient with persistent atrial fibrillation presented with a left atrial thrombus.
• The patient was treated with apixaban.

Findings:

• Complete resolution of the left atrial thrombus was observed after 16 days of apixaban treatment.
• Biomarkers including soluble fibrin and D-dimer levels decreased.
• International Normalized Ratio (INR) and Activated Partial Thromboplastin Time (APTT) remained within normal limits, indicating no significant anticoagulation-related laboratory changes.

Implications:

• Apixaban demonstrates potential efficacy in resolving LAA thrombus, a critical complication of atrial fibrillation.
• This case suggests apixaban may be a viable therapeutic option for LAA thrombosis, warranting further investigation.
• The findings contribute to understanding NOACs' role beyond stroke prevention in atrial fibrillation patients.