Thrombus formation in left atrium on Dabigatran therapy
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Dabigatran is a direct thrombin inhibitor. It binds to thrombin in competitive and reversible manner. Binding of dabigatran to thrombin prevents catalytic conversion of fibrinogen to fibrin by thrombin. It also inhibits thrombin-mediated activation of platelets and amplification of coagulation cascade. Although dabigatran 150 mg twice daily reduced the primary outcome of stroke/systemic embolism by 34% compared to warfarin in RE-LY trial , failure of this therapy can occur in occasional cases. We report one such rare case of left atrial thrombus formation in a patient with chronic atrial fibrillation on dabigatran therapy....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4352418/
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