Individualized anti-thrombotic therapy for acute myocardial infarction complicated with left ventricular thrombus: A case report  

作　　者：Yan Song Hua Li Xia Zhang Lei Wang Hong-Yan Xu Zhi-Chao Lu Xiao-Gang Wang Bo Liu 

机构地区：[1]Department of Clinical Pharmacy,Zibo Municipal Hospital,Zibo 255400,Shandong Province,China [2]Department of Cardiology,Zibo Municipal Hospital,Zibo 255400,Shandong Province,China [3]Department of Pharmacy,Zibo Municipal Hospital,Zibo 255400,Shandong Province,China [4]Department of Imaging,Zibo Municipal Hospital,Zibo 255400,Shandong Province,China [5]Department of Pulmonary and Critical Care Medicine,Department of Clinical Microbiology,Zibo City Key Laboratory of Respiratory Infection and Clinical Microbiology,Zibo City Engineering Technology Research Center of Etiology Molecular Diagnosis,Zibo Municipal Hospital,Zibo 255400,Shandong Province,China

出　　处：《World Journal of Clinical Cases》2024年第4期835-841,共7页世界临床病例杂志

摘　　要：BACKGROUND Presently,there is no established standard anti-blood clot therapy for patients facing acute myocardial infarction(AMI)complicated by left ventricular thrombus(LVT).While vitamin K antagonists are the preferred choice for oral blood thinning,determining the best course of blood-thinning medication remains challenging.It is unclear if non-vitamin K antagonist oral blood thinners have different effectiveness in treating LVT.This study significantly contributes to the medical community.CASE SUMMARY The blood-thinning treatment of a patient with AMI and LVT was analyzed.Triple blood-thinning therapy included daily enteric-coated aspirin tablets at 0.1 g,daily clopidogrel hydrogen sulfate at 75 mg,and dabigatran etexilate at 110 mg twice daily.After 15 d,the patient’s LVT did not decrease but instead increased.Clinical pharmacists comprehensively analyzed the cases from the perspective of the patient’s disease status and drug interaction.The drug regimen was reformulated for the patient,replacing dabigatran etexilate with warfarin,and was administered for six months.The clinical pharmacist provided the patient with professional and standardized pharmaceutical services.The patient’s condition was discharged after meeting the international normalized ratio value(2-3)criteria.The patient fully complied with the follow-up,and the time in the therapeutic range was 78.57%,with no serious adverse effects during pharmaceutical monitoring.CONCLUSION Warfarin proves to be an effective drug for patients with AMI complicated by LVT,and its blood-thinning course lasts for six months.

关 键 词：Myocardial infarction Left ventricular thrombus Dabigatran etexilate WARFARIN Clinical pharmacist Case report 

分 类 号：R542.2[医药卫生—心血管疾病]