Embolic stroke during apixaban therapy for left atrial appendage thrombus

Masaki Ohyagi, Kazuha Nakamura, Mutsufusa Watanabe, Hiroto Fujigasaki

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Left atrial appendage (LAA) thrombus is associated with atrial fibrillation (AF) and is a powerful predictor of cardiogenic thromboembolism. Warfarin is an established anticoagulant therapy for patients with LAA thrombus to prevent thromboembolic complications. Apixaban is superior to warfarin in the prevention of thromboembolic complications in patients with AF, and there are case reports showing apixaban-associated resolution of LAA thrombus; however, the efficacy and safety of apixaban for the treatment of LAA thrombus remains unproven. Here we report a patient who experienced embolic stroke while taking apixaban for the treatment of LAA thrombus. Thrombolysis therapy was initiated at the onset of stroke and the patient recovered remarkably. Apixaban is known to make thrombi mobile and/ or fragile by shifting the coagulation/fibrinolysis balance to a relative predominance of fibrinolytic activity; therefore, it is necessary to monitor for thromboembolic complications after the initiation of apixaban for the treatment of pre-existing LAA thrombus.

Original languageEnglish
Pages (from-to)e101-e102
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number4
Publication statusPublished - 2015
Externally publishedYes


  • Atrial fibrillation
  • Echocardiography
  • Novel oral anticoagulants
  • Thrombolysis

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine


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