Abrupt cessation of dabigatran may be associated with a rebound phenomenon of hypercoagulability leading to severe and fatal thromboembolic events.
May warrant caution with abrupt dabigatran discontinuation; leaves open rebound hypercoagulability in this single case.
Novel anticoagulants are increasingly utilised in lieu of warfarin to treat non-valvular atrial fibrillation. Their clinical use in other non-FDA approved settings is also increasing. We present a case in which a patient abruptly stopped taking dabigatran due to a small bowel obstruction and shortly thereafter suffered a myocardial infarction complicated by left ventricular thrombosis with fatal embolisation to the superior mesenteric artery. In this context, we discuss the possibility of a rebound phenomenon of hypercoagulability with abrupt cessation of novel anticoagulants.
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Weiler et al. (2014) studied this question.
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