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Venous Thromboembolism While on Anticoagulation With Apixaban.
Farah Mazahreh1, Fuad Habash1, Angel López-Candales2
1Cardiology, University of Arkansas for Medical Sciences, Little Rock, USA.
Cureus
|June 28, 2021
Summary
Direct oral anticoagulants (DOACs) are effective for venous thromboembolism (VTE), but treatment failure can occur. This case report details a patient experiencing a saddle pulmonary embolism despite being on apixaban therapy.
Area of Science:
- Cardiology
- Hematology
Background:
- Venous thromboembolism (VTE) pathophysiology involves Virchow's triad: stasis, hypercoagulability, and endothelial injury.
- Direct oral anticoagulants (DOACs) offer non-inferiority to traditional anticoagulants like heparin and warfarin.
- Treatment failure with DOACs remains a clinical challenge for healthcare providers.
Observation:
- A case report detailing a patient with VTE.
- The patient presented with a saddle pulmonary embolism.
- The event occurred while the patient was undergoing treatment with apixaban.
Findings:
- Despite current therapeutic standards, VTE can still occur.
- Apixaban, a commonly prescribed DOAC, did not prevent a major thromboembolic event in this case.
- This highlights the potential for treatment failure even with advanced anticoagulant therapies.
Implications:
- Physicians must remain vigilant for VTE treatment failure, even with DOACs.
- Further research may be needed to understand mechanisms of DOAC failure in specific patient populations.
- This case underscores the importance of individualized patient monitoring and risk assessment in anticoagulation management.
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