Resolution of a left ventricular thrombus by the thrombolytic action of dabigatran

Nagamoto, Yasutsugu; Shiomi, Tetsuya; Matsuura, Taku; Okahara, Arihide; Takegami, Kaoru; Mine, Daigo; Shirahama, Takaharu; Koga, Yasutoshi; Yoshida, Keiki; Sadamatsu, Kenji; Hayashida, Kentaro

doi:10.1007/s00380-013-0403-5

Cited by 48 publications

(42 citation statements)

References 17 publications

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“…Thrombus can be treated with warfarin, [12,13] but dabigatran can be considered an alternative to warfarin therapy. Five previous cases of dabigatran administration resulting in resolution of thrombus have been reported [7,[14][15][16][17]. The reported doses of dabigatran ranged from 220 to 300 mg/day, and resolution was confirmed after 3 weeks or longer (Table 1).…”

Section: Discussionmentioning

confidence: 86%

“…Dabigatran has also been used as an alternative to warfarin for prophylaxis against thromboembolism in patients with atrial fibrillation [8]. Dabigatran is thought to have a stronger thrombolytic effect compared with other drugs that enhance susceptibility to fibrinolysis [7,9]. Here, we describe two patients with old anteroseptal MI and LV thrombus, who were treated with dabigatran resulting in resolution of thrombus.…”

Section: Introductionmentioning

confidence: 99%

“…LV thrombus can resolve after warfarin therapy, [6] and has recently been shown to resolve after dabigatran therapy [7]. Dabigatran has also been used as an alternative to warfarin for prophylaxis against thromboembolism in patients with atrial fibrillation [8].…”

Section: Introductionmentioning

confidence: 99%

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Resolution of Left Ventricular Thrombus after Dabigatran Therapy in Two Patients with Old Anteroseptal Myocardial Infarction

Yamamoto¹

2015

Cardiol Pharmacol

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Dabigatran has been used recently as an alternative to warfarin therapy for the prevention of thromboembolism in patients with myocardial infarction or atrial fibrillation, but treatment of established intracardiac thrombus with dabigatran has seldom been reported. We report two patients with left ventricular (LV) thrombus who were successfully treated with dabigatran. The first patient was a 52-year-old man with no clear symptoms who was referred for investigation of abnormal electrocardiography findings, and the second patient was a 51-year-old man with recent onset of heart failure and a history of chest pain 1 month previously. Both patients were diagnosed with old anteroseptal myocardial infarction after echocardiography showed abnormal LV wall motion and LV thrombus. The thrombus was thought to be chronic in the first patient, and to have formed within the preceding month in the second patient. After treatment with dabigatran 220 mg/day and antiplatelet drugs, repeat echocardiography showed resolution of the thrombus after 6 weeks and 2 weeks, respectively. These cases illustrate that dabigatran 220 mg/ day may be useful for the treatment of established LV thrombus.

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Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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Resolution of Left Ventricular Thrombus after Dabigatran Therapy in Two Patients with Old Anteroseptal Myocardial Infarction

Yamamoto¹

2015

Cardiol Pharmacol

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“…[8] описывают случай растворения постин-фарктного тромба в полости ЛЖ при использовании ривароксабана в дозе 20 мг / сут в добавление к двой-ной антиагрегантной терапии (аспирин 100 мг / сут, клопидогрел 75 мг / сут). НПАГ успешно растворили тромб в полости ЛЖ в случае старого ИМ (дабигатран 220 мг / сут) [9] и в случае индуцированной тахикардией СН (ривароксабан 15 мг / сут) [10].…”

Section: Discussionunclassified

Efficiency of rivaroxaban in a patient with myocardial infarction and left ventricular thrombus

Beyshenkulov¹,

Usupbaeva²,

Kaliev³

et al. 2017

RHJ

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“…Na uwagę zasługuje praca Nagamoto i wsp. [10], w której udokumentowano skuteczność dabigatranu w dawce 2 × 110 mg w rozpuszczaniu przyściennej skrzepliny w obrębie akinetycznego, pozawałowego segmentu lewej komory.…”

Section: Dyskusjaunclassified

Right ventricular thrombus successfully dissolved with novel oral anticoagulant therapy

Wybraniec¹,

Mizia²,

Myszor³

et al. 2016

Kardiol Pol

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Samodzielny Publiczny Szpital Kliniczny nr 7, Śląski Uniwersytet Medyczny, Górnośląskie Centrum Medyczne im. prof. Leszka Gieca, Katowice S t r e s z c z e n i ePacjentka w wieku 71 lat bez objawów podmiotowych została przyjęta na Oddział Kardiologii z powodu zmiany w obrę-bie koniuszka prawej komory, przypadkowo stwierdzonej w tomografii komputerowej jamy brzusznej. W przezklatkowym badaniu echokardiograficznym zaobserwowano hipoechogeniczną, przyścienną strukturę o morfologii skrzepliny w świetle prawej komory (o wymiarach 32 mm × 16 mm) z obecnością hipokinezy przyległych segmentów ściany serca. W trakcie hospitalizacji wykluczono obecność choroby wieńcowej, zatorowości płucnej i systemową chorobę tkanki łącznej. Za pomocą rezonansu magnetycznego serca uwidoczniono hipointensywną skrzeplinę w koniuszku prawej komory, a kontrolna tomografia komputerowa serca potwierdziła stabilne wymiary i charakter zmiany. Na podstawie powyższego obrazu klinicznego wdrożono przewlekłe leczenie przeciwkrzepliwie nowymi doustnymi antykoagulantami (NOAC). Kontrolne badanie echokardiograficzne wykonane po 3 miesiącach od wypisania ze szpitala wykazało całkowitą regresję skrzepliny i normalizację odcinkowych zaburzeń kurczliwości prawej komory. Niniejszy opis przypadku dokumentuje możliwość zastosowania NOAC w celu leczenia incydentalnej, przyściennej skrzepliny w prawej komorze. Słowa kluczowe: nowe doustne antykoagulanty, NOAC, dabigatran, przyścienna skrzeplina, prawa komora A b s t r a c tA 71-year-old asymptomatic female was admitted to the department of cardiology on account of incidental finding of a tumour-like mass located in the apex of right ventricle, which was revealed during contrast-enhanced computed tomography of the abdominal cavity. Transthoracic echocardiography showed hypoechogenic right ventricular mass (32 mm × 16 mm), suggestive of thrombus with hypokinesia of the surrounding right ventricular wall. Coronary artery disease, connective tissue disease and pulmonary embolism were excluded. Cardiac magnetic resonance imaging indicated the presence of hypo-intense mural thrombus, while repeated computed tomography confirmed stable size and character of the lesion. The anticoagulation therapy with novel oral anticoagulant (NOAC) was instituted. Following three months of treatment, the echocardiographic assessment confirmed complete disappearance of thrombus and resolution of regional wall motion abnormalities. The present case indicates that NOAC can be utilised as effective agents in case of incidental right ventricular mural thrombus, unrelated to pulmonary embolism.

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Resolution of a left ventricular thrombus by the thrombolytic action of dabigatran

Cited by 48 publications

References 17 publications

Resolution of Left Ventricular Thrombus after Dabigatran Therapy in Two Patients with Old Anteroseptal Myocardial Infarction

Resolution of Left Ventricular Thrombus after Dabigatran Therapy in Two Patients with Old Anteroseptal Myocardial Infarction

Efficiency of rivaroxaban in a patient with myocardial infarction and left ventricular thrombus

Right ventricular thrombus successfully dissolved with novel oral anticoagulant therapy

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