A Case of Pulmonary Embolism on Dabigatran

Abstract

It is well known that hospitalized medical patients are at higher risk for the development of venous thromboembolism. As a result patients are placed on standard prophylactic anticoagulation. As newer anticoagulants are coming to the market patients on these novel oral agents are continued on them instead of being transitioned to the standard therapies.Dabigatran, one of the newer agents, is an oral direct thrombin inhibitor (DTI) approved for anticoagulation in non-valvular atrial fibrillation and DVT prophylaxis in post-operative patients after knee and hip surgeries. Dabigatran is an effective anticoagulant because DTIs suppress thrombus growth []. We report a case of extensive pulmonary emboli in a patient taking dabigatran. Although dabigatran is not currently approved for DVT/VTE prophylaxis in the hospitalized medical patient, recent studies demonstrate its non-inferiority compared with warfarin in the prevention of recurrent VTE. In light of this, we argue that our patient constitutes a treatment failure.




J Med Cases. 2013;4(8):550-551
doi: https://doi.org/10.4021/jmc1400w