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CASE REPORT
Year : 2020  |  Volume : 5  |  Issue : 2  |  Page : 30-32

Acute decompensated heart failure increases the anticoagulation effect of dabigatran: A case report


1 Department of Cardiovascular Surgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China
2 Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, China

Correspondence Address:
Dr. Mingfang Li
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu Province
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhr.ijhr_8_20

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Dabigatran is a widely used non-Vitamin K antagonist oral anticoagulant and has demonstrated a better efficacy and safety profile compared to Vitamin K antagonists. However, in some specific situations, the bleeding risk of dabigatran will be much increased. A 76-year-old female atrial fibrillation patient with concomitant nonrheumatic mitral valve regurgitation and chronic heart failure was described. She was on dabigatran 110 mg twice a day. On day 2 after admission, the patient presented with acute decompensated heart failure, the creatinine clearance level markedly decreased from 40.9 mL/min to 23.1 mL/min, and the trough-activated partial thromboplastin time exceeded the detection range. In this clinical context, renal and coagulation function should be monitored closely to avoid severe adverse events, especially major bleeding. Low-molecular-weight heparin might be considered to be applied temporarily, and rivaroxaban may be prescribed in this condition. The ethical approval was waived by the institutional review board of our hospital owing to the retrospective nature of the study.


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