Combined treatment with several drugs affecting the coagulation system – what do we gain? At what cost? – the Warsaw center experience Case report
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Published:
Sep 30, 2019
Keywords:
triple anticoagulation therapy, idarucizumab, perioperative bleeding
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Abstract
A 68-year-old man with hypertension, hypertrophic cardiomyopathy, chronic obstructive pulmonary disease, Hashimoto’s disease, treated for paroxysmal atrial fibrillation with dabigatran 2 × 150 mg. The emergency team called for a chest pain, suspected of having an acute coronary syndrome, gave the patient loading doses of ASA and clopidogrel. Finally aortic dissection with urgent indications for surgical treatment was diagnosed. Idarucizumab, an antidote for dabigatran, has been administered, but it has not been possible to reverse the effect of antiplatelet therapy. The patient died after surgery due to hemorrhagic complications.
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How to Cite
Banaszewski, M., & Stępińska, J. (2019). Combined treatment with several drugs affecting the coagulation system – what do we gain? At what cost? – the Warsaw center experience. Medycyna Faktow (J EBM), 12(3(44), 204-208. https://doi.org/10.24292/01.MF.0319.3
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References
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2. Hawes E.M., Deal A.M., Funk-Adcock D.: Performance of coagulation tests in patients on therapeutic doses of dabigatran: a cross-sectional pharmacodynamic study. J. Thromb. Haemost. 2013; 11: 1493-1502.
3. Heidbuchel H., Verhamme P., Alings M. et al.: European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace 2013; 15(5): 625-651.
4. Kirchhof P., Benussi S., Kotecha D. et al.: 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur. Heart J. 2016; 37(38): 2893--2962.
5. Pollack C.V. Jr, Reilly P.A., van Ryn J. et al.: Idarucizumab for dabigatran reversal – full cohort analysis. N. Engl. J. Med. 2017; 377: 431-441.
6. Steffel J., Verhamme P., Potpara T.S. et al.: The 2018 European Heart Rhythm Association Practical Guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Eur. Heart J. 2018; 39(16): 1330-1393.