Key result
Idarucizumab rapidly reverses dabigatran anticoagulation, enabling successful pericardiocentesis in severe hemopericardium.
Why the study?
Does idarucizumab successfully reverse life-threatening hemopericardium related to dabigatran use?
Case Report (n=1)
Does idarucizumab successfully reverse life-threatening hemopericardium related to dabigatran use?
This case report provides the first clinical evidence of successful reversal of dabigatran-induced hemopericardium using idarucizumab in a high-risk cancer patient.
May support idarucizumab reversal in dabigatran hemopericardium; hypothesis-generating and requires prospective confirmation.
Dabigatran, the first novel oral anticoagulant (NOAC) with a reversal agent, heralded a paradigm shift in the treatment of nonvalvular atrial fibrillation. The potential for life-threatening hemorrhagic events with the use of NOACs has been highly debated since the effectiveness of reversal agents such as idarucizumab is based primarily on pharmacologic data. It is known that cancer patients are at an increased risk of bleeding with anticoagulation, though specific studies demonstrating the risks or efficacy of NOACs in this population are lacking. We provide the first report of hemopericardium resulting in multiorgan failure related to dabigatran use that was successfully reversed by idarucizumab in a man with prostate cancer on chemotherapy.
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Song et al. (2017) conducted a case report in Hemopericardium related to dabigatran use (n=1). Idarucizumab was evaluated on Reversal of anticoagulation and clinical recovery. Administration of idarucizumab rapidly reversed dabigatran-induced anticoagulation, normalizing aPTT from 47.7 to 29.5 seconds and enabling successful pericardiocentesis for severe hemopericardium.
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