Key result
A 66-year-old female treated with dabigatran etexilate for one year developed life-threatening hemopericardium and cardiac tamponade associated with acute renal failure and an elevated INR.
Case Report (n=1)
No
Dabigatran use can lead to life-threatening hemopericardium and cardiac tamponade, especially when acute renal failure causes drug accumulation.
Answers are grounded in this paper and cite their sources.
Alerts clinicians to possible dabigatran tamponade in renal failure; single case leaves incidence and prevention open.
Dabigatran etexilate is one of the new oral anticoagulants approved to reduce the risk of stroke in patients with atrial fibrillation (AF). A variety of bleeding complications with dabigatran have been reported, but reports of hemopericardium are rare. We described a case of a 66 year-old female patient with non-valvular AF receiving dabigatran etexilate 150 mg twice daily for one year who suffered from hemopericardium. Her laboratory tests performed 1 year prior were normal and her admission tests revealed acute renal failure and elevated international normalized ratio (INR) level (4.79). Urgent pericardiocentesis was followed by improved renal functions and normalized INR. Dabigatran etexilate is a new oral anticoagulant that is increasingly used in daily practice. However, life-threatening complications warrant caution. Elevated INR may be related with overdose but the association of bleeding risk of dabigatran and INR requires further confirmation.
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Kızılırmak et al. (2016) conducted a case report in Non-valvular atrial fibrillation (n=1). Dabigatran etexilate was evaluated. A 66-year-old female treated with dabigatran etexilate for one year developed life-threatening hemopericardium and cardiac tamponade associated with acute renal failure and an elevated INR.
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