Successful resolution of a left ventricular thrombus with apixaban treatment following acute myocardial infarction

Yoshinori Mano, Kimi Koide, Hiroaki Sukegawa, Masaki Kodaira, Takahiro Ohki

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)

Abstract

A 62-year-old man was admitted to our emergency department owing to prolonged chest pain that had lasted for 3 h. An electrocardiogram showed ST elevation in leads I, aVL, and V1-6, and the patient’s laboratory revealed elevated myocardial necrosis marker levels. Emergency coronary angiography showed total occlusion of the proximal left anterior descending coronary artery. Subsequent percutaneous coronary intervention was performed by balloon angioplasty followed by stent implantation, and the patient showed improvement. However, echocardiographic examination 2 weeks after the percutaneous coronary intervention showed a thrombus (40 × 14 mm) in the apex of the left ventricle. In addition to dual antiplatelet therapy, apixaban was administered as anticoagulant therapy for the left ventricular thrombus. The size of the thrombus gradually decreased, and magnetic resonance imaging performed approximately 6 weeks after the initial apixaban administration showed no thrombus without a thromboembolic event. This case demonstrates that left ventricular thrombus can be resolved with apixaban treatment. Apixaban may be an effective alternative to vitamin K antagonist for some patients with acute myocardial infarction complicated by left ventricular thrombus.

Original languageEnglish
Pages (from-to)118-123
Number of pages6
JournalHeart and vessels
Volume31
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1
Externally publishedYes

Keywords

  • Acute myocardial infarction
  • Apixaban
  • Left ventricular thrombus
  • Triple antithrombotic therapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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