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- Title
Rivaroxaban as an effective alternative to warfarin in a patient with atrial fibrillation, thrombophilia, and left atrial appendage thrombus: a case report.
- Authors
Scarano, Michele; Casale, Matteo; Mantini, Cesare; Imbalzano, Egidio; Consorti, Cristiana; Clemente, Daniela; Dattilo, Giuseppe
- Abstract
<bold>Background: </bold>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.<bold>Case Presentation: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
HYPERCOAGULATION disorders; RIVAROXABAN; DRUG therapy; WARFARIN; THROMBOSIS diagnosis; THERAPEUTICS
- Publication
Journal of Medical Case Reports, 2017, Vol 11, p1
- ISSN
1752-1947
- Publication type
journal article
- DOI
10.1186/s13256-017-1249-8