Abstract
Left atrial appendage (LAA) thrombosis is an important cause of cardiogenic cerebral thromboembolism. Apixaban is a member of the class of novel oral anticoagulants (NOAC) and is superior to warfarin in preventing stroke or systemic embolism, causes less bleeding, and results in lower mortality in patients with atrial fibrillation. There are few reports of resolution of LAA thrombus with other NOAC. We present a 72-year-old male patient with persistent atrial fibrillation associated with left atrial thrombus. Sixteen days of apixaban treatment showed complete thrombus resolution. In this study, soluble fibrin and D-dimer levels decreased without prolongation of international normalized ratio (INR) and activated partial thromboplastin time (APTT).
Highlights
Left atrial appendage (LAA) thrombus is commonly associated with atrial fibrillation (AF) and causes thromboembolic complications
Warfarin is used for prevention of thromboembolic complications with AF patients and resolution of LAA thrombus [1]
Apixaban is a member of the class of novel oral anticoagulants (NOAC)
Summary
Left atrial appendage (LAA) thrombus is commonly associated with atrial fibrillation (AF) and causes thromboembolic complications. On hospital admission the patient presented with functional NYHA class III; he had a clinical history of non-ischemic cardiomyopathy with severely impaired left ventricular function and a moderate AF-related thromboembolic risk with an actual CHA2DS2VASc score of 3, and had not been pretreated with anticoagulant. We determined that he required rapid anticoagulation to be delivered orally. SF in sodium citrate plasma was measured with Nanopia SF (Sekisui Medical Co., Ltd.). Plasma was measured with Nanopia D-dimer (Sekisui Medical Co., Ltd.). Processing and analyses were performed within 90 minutes of sample collection
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