Spontaneous rebound of the anticoagulant effect of accumulated dabigatran after the antagonist activity cessation: Case report of life-threatening haemorrhage
Abstract
NOAC (Non-Vitamin K Oral Anticoagulants) are currently increasingly used for treatment of thromboembolism. The main reason for their popularity is the possibility of oral application without the need to monitor their effect.
In our report we describe the case of an 81-year-old man with paroxysmal atrial fibrillation treated with dabigatran, which accumulated in the patient, resulting in a life-threatening gastrointestinal bleeding. The patient was first treated with a prothrombin complex concentrate and then the selective dabigatran antagonist idarucizumab.
An important finding from the case report was the existence of rebound phenomenon of returning anticoagulant activity of NOAC after application of idarucizumab due to accumulation of the dabigatran.