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Dabigatran as an alternative for atrial thrombosis resistant to rivaroxaban: A case report

Huan Sun1,2,3, Qini Zhao1,2,3, Yanjing Wang4

  • 1Cardiology Department, China-Japan Union Hospital of Jilin University.

Medicine
|December 22, 2018
PubMed

Insights

Switching novel oral anticoagulants (NOACs) may be effective when initial treatment fails. This case study highlights individualized patient response to NOACs for atrial fibrillation stroke prevention.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Atrial fibrillation (AF) management requires effective anti-thrombosis therapy for stroke prevention.
  • Novel oral anticoagulants (NOACs) are guideline-recommended for AF, but switching between them is not fully understood.

Observation:

  • A 52-year-old male patient with heart failure and AF presented with a left atrial thrombus.
  • Cardiomyopathy was diagnosed via cardiac magnetic resonance (CMR) and echocardiography.

Findings:

  • Initial treatment with rivaroxaban (20 mg daily) failed to reduce the atrial thrombus.
  • Switching to dabigatran (150 mg twice daily) successfully eliminated the thrombus.

Implications:

  • Individualized patient responsiveness to NOACs is crucial in clinical practice.
  • This case suggests that switching NOACs can be a viable strategy for non-responsive cases.
Abstract

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