Work

Possible Factor Xa Resistance in a Patient Who Failed Apixaban and Rivaroxaban

Year: 2024

Type: article

Abstract: This article aims to discuss the literature on switching to an anticoagulant with a different mechanism of action in case of treatment failure. We present a patient with atrial fibrillation who incurred an embolic stroke despite adequate anticoagulation with apixaban and developed a new symptomatic ischemic stroke during the same admission after switching to rivaroxaban, a factor Xa inhibitor with a similar mechanism of action. He had no new events at 3-months after switching to dabigatran, a direct thrombin inhibitor. We identified no apparent reason for anticoagulation failure in our patient. The literature on switching anticoagulants in case of failure is inconclusive with no strong supportive evidence. More research is needed to define anticoagulation failure and identify cases with factor Xa inhibitor resistance, in which switching to a different mechanism of anticoagulation may be appropriate.

Source: Clinical Case Reports

DOI: 10.1002/ccr3.9623

Authors: Ola Ali, Awab Elnaeem, Manmeet Kaur, Nitisha Thatikonda, Julia Aigbogun, A. K. M. Muktadir

Institutions: University of Bahri, The University of Texas Medical Branch at Galveston

Language: English

Topic: Atrial Fibrillation Management and Outcomes

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,730