Miwa Yosuke, Minamishima Toshinori, Sato Toshiaki, Sakata Konomi, Yoshino Hideaki, Soejima Kyoko
Department of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan.
J Arrhythm. 2016 Jun;32(3):233-5. doi: 10.1016/j.joa.2016.01.009. Epub 2016 Mar 15.
The majority of embolisms associated with atrial fibrillation (AF) are from the left atrial appendage (LAA). To treat the existing thrombus, warfarin and novel anticoagulants have been used. However, there has been no clinical information regarding the difference of the effects of congealing the fibrinogenolysis system among these oral anticoagulants. Here, we report a case of persistent AF, in whom apixaban, factor Xa inhibitor resolved an LAA clot refractory to warfarin and direct thrombin inhibition. Factor Xa inhibitor, apixaban, could resolve the left appendage thrombosis refractory to warfarin and dabigatran.
大多数与心房颤动（AF）相关的栓塞来自左心耳（LAA）。为了治疗现有的血栓，已使用华法林和新型抗凝剂。然而，关于这些口服抗凝剂在凝固纤维蛋白溶解系统方面的效果差异，尚无临床信息。在此，我们报告一例持续性AF患者，阿哌沙班（一种Xa因子抑制剂）使该患者对华法林和直接凝血酶抑制均难治的LAA血栓溶解。Xa因子抑制剂阿哌沙班能够溶解对华法林和达比加群均难治的左心耳血栓形成。
