Many anticoagulants are indicated as prophylaxis and treatment for conditions that may lead to thromboembolisms or atrial fibrillation. Among those, apixaban, a reversible direct inhibitor of factor Xa, is one of the most popular. Apixaban is known to cause a variety of side effects; however, for this paper, the focus is on hypersensitivity reactions. Although several cases will be referenced from the literature, we present a case with a history of a dermatological disease before the use of a direct oral anticoagulant. A 74-year-old female patient with a history of pemphigus vulgaris and a diagnosis of pulmonary embolism and right distal vein thrombosis managed with apixaban presented with a pruritic coalescent erythematous dermatitis throughout her torso, back, and lower extremities three days post-apixaban treatment. In accordance with her physical examination, the apixaban regimen was withdrawn, and oral dabigatran, a direct thrombin inhibitor, was initiated. At the patient's five-day follow-up, clinical improvement was noted. Through clinical diagnosis, it is believed that this dermatitis was a reaction to the apixaban treatment course.
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http://dx.doi.org/10.7759/cureus.50273 | DOI Listing |
Cochrane Database Syst Rev
January 2025
Department of Pharmacy Practice, University of Connecticut, Storrs, CT 06269, USA.
Background: Guideline-recommended strategies to interrupt chronic anticoagulation with warfarin or direct oral anticoagulants (DOAC) during the perioperative period of cardiac implantable electronic device (CIED) surgery differ worldwide. There is uncertainty concerning the benefits and harms of interrupted and uninterrupted anticoagulation in patients undergoing CIED surgery.
Objectives: To assess the benefits and harms of interrupted anticoagulation (IAC) with either warfarin or DOAC in the perioperative period of CIED surgery versus uninterrupted anticoagulation (UAC), with or without heparin bridging, during an equivalent time frame, for CIED surgery.
Clin Cardiol
January 2025
Department of Cardiology, Firat University Hospital, Elazig, Türkiye.
Objective: The main objective of this study is to determine the incidence and predictors of clinical outcomes in patients with AF treated with factor Xa inhibitors in a real-world setting.
Methods: The present study was a multicentre and observational study that included patients with AF who were treated with factor Xa inhibitors. The primary outcome was the composite of ischemic stroke, TIA, systemic embolism, major bleeding, and all-cause mortality.
JAMA Neurol
January 2025
Department of Neurology, UAB Heersink School of Medicine, University of Alabama at Birmingham, Birmingham.
Importance: In the Atrial Cardiopathy and Antithrombotic Drugs in Prevention After Cryptogenic Stroke (ARCADIA) randomized clinical trial, anticoagulation did not prevent recurrent stroke among patients with a recent cryptogenic stroke and atrial cardiopathy. It is unknown whether anticoagulation prevents covert infarcts in this population.
Objective: To test the use of apixaban vs aspirin for prevention of nonlacunar covert infarcts after cryptogenic stroke in patients with atrial cardiopathy.
ASAIO J
January 2025
From the Intensive Cardiac Care Unit, Cardiology Department, Rangueil University Hospital, Toulouse, France.
Radiol Case Rep
March 2025
Department of Radiology, Rafidia Surgical Hospital, Nablus, Palestine.
May-Thurner syndrome (MTS), iliac vein compression syndrome, also called Cockett syndrome, is a vascular disease caused by the compression of the left common iliac vein (LCIV) by the right common iliac artery (RCIA) against the lumbar vertebrae. This anatomical defect can lead to venous stasis especially in the left lower limb, and this increases the risk of deep venous thrombosis (DVT). Because routine screening is not standard practice, MTS frequently remains asymptomatic, and its prevalence is probably underestimated.
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