Rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation, thrombophilia, and left atrial appendage thrombus: a case report
Abstract Background Atrial fibrillation is the most common cardiac arrhythmia. It is responsible for up to 20% of all ischemic strokes. Rate control and anticoagulation are crucial for atrial fibrillation management and stroke prevention. Case presentation We present the case of an 84-year-old Itali...
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| Format: | Article |
| Language: | English |
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BMC
2017-04-01
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| Series: | Journal of Medical Case Reports |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13256-017-1249-8 |
| _version_ | 1818518845931913216 |
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| author | Michele Scarano Matteo Casale Cesare Mantini Egidio Imbalzano Cristiana Consorti Daniela Clemente Giuseppe Dattilo |
| author_facet | Michele Scarano Matteo Casale Cesare Mantini Egidio Imbalzano Cristiana Consorti Daniela Clemente Giuseppe Dattilo |
| author_sort | Michele Scarano |
| collection | DOAJ |
| description | Abstract Background Atrial fibrillation is the most common cardiac arrhythmia. It is responsible for up to 20% of all ischemic strokes. Rate control and anticoagulation are crucial for atrial fibrillation management and stroke prevention. Case presentation We present the case of an 84-year-old Italian woman with a left atrial appendage thrombus that developed despite her use of anticoagulant therapy with warfarin for a previous pulmonary embolism. She had atrial fibrillation and heterozygosity for both factor V Leiden and methylenetetrahydrofolate reductase C677T mutation, thus creating resistance to activated protein C. Anticoagulant therapy was switched to heparin for 1 week and then to rivaroxaban. After 3 months of rivaroxaban use, the thrombus disappeared. Conclusions This case raises the issue of the ineffectiveness of warfarin therapy in complex cases involving particular thrombophilic conditions and the possibility of using rivaroxaban as a safe and effective alternative. |
| first_indexed | 2024-12-11T01:15:55Z |
| format | Article |
| id | doaj.art-c9125713dcee468db0366e40a38b1029 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-11T01:15:55Z |
| publishDate | 2017-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-c9125713dcee468db0366e40a38b10292022-12-22T01:25:52ZengBMCJournal of Medical Case Reports1752-19472017-04-011111410.1186/s13256-017-1249-8Rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation, thrombophilia, and left atrial appendage thrombus: a case reportMichele Scarano0Matteo Casale1Cesare Mantini2Egidio Imbalzano3Cristiana Consorti4Daniela Clemente5Giuseppe Dattilo6Cardiology Unit, Emergency Department, Hospital “Madonna del Soccorso”Department of Clinical and Experimental Medicine, University of Messina“Gabriele D’Annunzio” UniversityDepartment of Clinical and Experimental Medicine, University of MessinaCardiology Unit, Emergency Department, Hospital “Madonna del Soccorso”Cardiology Unit, Emergency Department, Hospital “Madonna del Soccorso”Department of Clinical and Experimental Medicine, University of MessinaAbstract Background Atrial fibrillation is the most common cardiac arrhythmia. It is responsible for up to 20% of all ischemic strokes. Rate control and anticoagulation are crucial for atrial fibrillation management and stroke prevention. Case presentation We present the case of an 84-year-old Italian woman with a left atrial appendage thrombus that developed despite her use of anticoagulant therapy with warfarin for a previous pulmonary embolism. She had atrial fibrillation and heterozygosity for both factor V Leiden and methylenetetrahydrofolate reductase C677T mutation, thus creating resistance to activated protein C. Anticoagulant therapy was switched to heparin for 1 week and then to rivaroxaban. After 3 months of rivaroxaban use, the thrombus disappeared. Conclusions This case raises the issue of the ineffectiveness of warfarin therapy in complex cases involving particular thrombophilic conditions and the possibility of using rivaroxaban as a safe and effective alternative.http://link.springer.com/article/10.1186/s13256-017-1249-8Atrial fibrillationRivaroxabanThrombophiliaThrombosisWarfarinCase report |
| spellingShingle | Michele Scarano Matteo Casale Cesare Mantini Egidio Imbalzano Cristiana Consorti Daniela Clemente Giuseppe Dattilo Rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation, thrombophilia, and left atrial appendage thrombus: a case report Journal of Medical Case Reports Atrial fibrillation Rivaroxaban Thrombophilia Thrombosis Warfarin Case report |
| title | Rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation, thrombophilia, and left atrial appendage thrombus: a case report |
| title_full | Rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation, thrombophilia, and left atrial appendage thrombus: a case report |
| title_fullStr | Rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation, thrombophilia, and left atrial appendage thrombus: a case report |
| title_full_unstemmed | Rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation, thrombophilia, and left atrial appendage thrombus: a case report |
| title_short | Rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation, thrombophilia, and left atrial appendage thrombus: a case report |
| title_sort | rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation thrombophilia and left atrial appendage thrombus a case report |
| topic | Atrial fibrillation Rivaroxaban Thrombophilia Thrombosis Warfarin Case report |
| url | http://link.springer.com/article/10.1186/s13256-017-1249-8 |
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