Key result
Dabigatran as part of double antithrombotic therapy was utilized in an elderly patient with type 2 myocardial infarction, paroxysmal atrial fibrillation, and high hemorrhage risk.
Why the study?
Selecting optimal antithrombotic drugs and duration remains challenging in patients with acute coronary syndrome and atrial fibrillation given the increasing use of NOACs and novel antiplatelet agents.
Case Report (n=1)
Personalized risk assessment can guide the use of dabigatran in dual antithrombotic therapy for complex patients with MI, AF, and high bleeding risk.
Current clinical practice faces the challenges in selecting optimal drugs and the duration of antithrombotic treatment in patients with acute coronary syndrome with atrial fibrillation. A continuous increase of using non-vitamin K oral anticoagulants (NOAC), dabigatran, rivaroxaban, apixaban, edoxaban, and novel antiplatelet agents, prasugrel and ticagrelor, has complicated the decision-making process in this group of patients. The presented clinical case reports the use of dabigatran as a part of double antithrombotic therapy in an elderly patient with type 2 myocardial infarction, paroxysmal AF and a high risk for hemorrhage. The drug choice and its dosage were chosen using the personalized risk assessment. The presented approach has been early proved by the results of the recent randomized clinical trials and, therefore, may be translated into routine clinical practice.
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Pecherina et al. (2019) conducted a case report in Type 2 myocardial infarction, paroxysmal atrial fibrillation, and high risk for hemorrhage (n=1). Dabigatran (as part of double antithrombotic therapy) was evaluated. Dabigatran as part of double antithrombotic therapy was utilized in an elderly patient with type 2 myocardial infarction, paroxysmal atrial fibrillation, and high hemorrhage risk.
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