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Background: Novel oral anticoagulants are used in atrial fibrillation. Idarucizumab has been approved for reversal of dabigatran in situations of life-threatening hemorrhage or emergency surgery.
Objectives: We report a single center experience of ten patients on dabigatran therapy who were given idarucizumab prior to heart transplantation.
Methods & Results: The mean plasma concentration of dabigatran prior to reversal was 139 ± 89 ng/ml. Hemoglobin, hematocrit and platelet levels were decreased after surgery. Surgical procedures were successfully performed with no increased risk, especially regarding bleeding complications. All patients were alive after 90 days.
Conclusion: Dabigatran reversal with idarucizumab in contexts of emergency surgery/urgent procedures is an attractive and safe option to be taken into consideration for patients with end stage heart disease awaiting transplantation and indication of anticoagulant therapy.
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http://dx.doi.org/10.2144/fsoa-2020-0186 | DOI Listing |
Intern Emerg Med
August 2025
Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.
There are no real-world data on the modalities and outcomes of managing major or life-threatening bleeding related to oral anticoagulants in the emergency room (ER). The primary endpoint of this prospective observational study was to evaluate the therapeutic regimen ER physicians started to manage bleeding and 30-day mortality. The secondary endpoint was to evaluate the appropriateness of DOACs prescription and hospital admissions.
View Article and Find Full Text PDFCost Eff Resour Alloc
July 2025
School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, 1/F Patrick Manson Building, 7 Sassoon Rd, Pokfulam, Hong Kong (SAR), China.
Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults, associated with significant morbidity, mortality, and economic burden due to thromboembolic events. In Chile, acenocoumarol is the most widely used anticoagulant, while access to direct oral anticoagulants (DOACs) such as dabigatran, rivaroxaban, and apixaban remains limited for AF patients. Among DOACs, dabigatran is the only one with an approved specific reversal agent (idarucizumab) available in the Chilean public system.
View Article and Find Full Text PDFOrv Hetil
July 2025
2 Semmelweis Egyetem, Általános Orvostudományi Kar, Intenzív Terápiás Klinika, Aneszteziológiai és Intenzív Terápiás Tanszék Budapest, Pf. 2, 1428 Magyarország.
Direct oral anticoagulants have become first-line agents in anticoagulation therapy in recent years; however, their reversal may be challenging in emergency situations, such as massive bleeding or urgent surgery. Conventional coagulation tests are not suitable for accurately assessing anticoagulant activity, making specific monitoring methods (e.g.
View Article and Find Full Text PDFSci Rep
July 2025
Department of Clinical Pharmacology and Toxicology, Anam Hospital, University College of Medicine, Seoul, 02841, Korea.
Dabigatran acylglucuronide, an active metabolite of dabigatran, exhibits higher plasma concentrations and distinct anticoagulant effects compared to dabigatran, suggesting that it may play a more significant role in overall anticoagulant activity than previously assumed. Idarucizumab, a monoclonal antibody fragment, binds to both free and thrombin-bound dabigatran, neutralizing its anticoagulant effects. However, its efficacy in reversing anticoagulation induced by dabigatran acylglucuronide remains unclear.
View Article and Find Full Text PDFJ Pharmacol Exp Ther
July 2025
Emergency Department, Centre hospitalier universitaire Clermont-Ferrand, Clermont-Ferrand, France; Université Clermont Auvergne, Institut national de recherche pour l'agriculture, l'alimentation et l'environnement, Unité de Nutrition humaine, Unité de Nutrition Humaine, Centre de recherche en Nut