Open AccessBariatric Surgery can Lower the Efficacy of DOACs
Author(s) -
Zouheir Bitar,
Ossama Maadarani,
Mohammad Mohsen,
Nawal Usamah Alkazemi
Publication year - 2020
Publication title -
european journal of case reports in internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
H-Index - 1
ISSN - 2284-2594
DOI - 10.12890/2020_001954
Subject(s) - medicine , apixaban , vitamin k antagonist , sleeve gastrectomy , surgery , pulmonary embolism , deep vein , antithrombotic , pharmacodynamics , rivaroxaban , thrombosis , abdominal surgery , warfarin , gastric bypass , weight loss , atrial fibrillation , obesity , pharmacokinetics
A 39-year-old woman who was taking the contraceptive pill was admitted with right leg deep venous thrombosis (DVT). She was started on apixaban tablets, but after 8 days developed proximal progression of the DVT and pulmonary embolism. Her medical history later showed a history of sleeve gastrectomy. The patient responded to a vitamin K antagonist after heparin. The failure of the antithrombotic drug shed light on the efficacy and changed pharmacodynamics of direct oral anticoagulants (DOACs) after bariatric surgery in the absence of commercially available blood monitoring tests.