Apixaban 2.5 mg twice daily almost completely resolved a large left atrial thrombus in an 86-year-old man with persistent atrial fibrillation over 11 weeks without bleeding complications.
Case Report (n=1)
No
Does apixaban 2.5 mg twice daily resolve left atrial thrombus in an elderly patient with persistent atrial fibrillation?
Apixaban 2.5 mg twice daily may be an effective and safe alternative to warfarin for resolving left atrial thrombus in elderly patients with atrial fibrillation and renal dysfunction.
An 86-year-old man had long-standing persistent atrial fibrillation, but had not received any anticoagulants. Transthoracic echocardiography revealed a large thrombus formation in the left atrium. We hesitated to use the conventional anticoagulant, warfarin, because he was very old and had dementia. We decided to resolve the thrombus at our outpatient clinic. He was started on the novel oral anticoagulant, apixaban, 2.5 mg twice daily, which is a direct factor Xa (FXa) inhibitor. After 11 weeks on that therapy, the thrombus formation had almost resolved. During oral anticoagulant therapy, no serious bleeding complications, systemic embolisms or strokes were noted. To the best of our knowledge, we are the first to report that apixaban (5 mg/day) can possibly resolve a thrombus formation in the left atrium.
Dobashi et al. (Tue,) conducted a case report in Left atrial thrombus and persistent atrial fibrillation (n=1). Apixaban was evaluated on Resolution of left atrial thrombus. Apixaban 2.5 mg twice daily almost completely resolved a large left atrial thrombus in an 86-year-old man with persistent atrial fibrillation over 11 weeks without bleeding complications.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: