Successful use of rivaroxaban achieving therapeutic anti-factor xa levels in a morbidly obese patient with acute intermediate high risk pulmonary embolism

Kingsley Dah, Mateo Porres-Aguilar, Alan De la Rosa, Swathi Prakash

Research output: Contribution to journalArticlepeer-review

Abstract

Direct oral anticoagulants (DOACs) have become the standard of care for acute and long-term therapy for venous thromboembolism (VTE) due to their efficacy and safety profiles. The 2021 International Society on Thrombosis and Haemostasis guidelines recommend using standard DOAC dosages in patients with BMI >40 kg/m2 or weight >120 kg. Use of DOACs remains uncertain in morbidly obese patients with VTE, including acute PE. A morbidly obese woman in her 30s who presented with acute worsening of dyspnea was diagnosed with acute intermediate-high risk acute pulmonary embolism and concomitant proximal deep vein thrombosis, constituting a clinically challenging scenario for treating her with rivaroxaban. Standard doses of rivaroxaban for acute and extended phase treatment of venous thromboembolism in individuals with morbid obesity at BMI>70 kg/m2 may be effective, and safe.

Original languageEnglish (US)
Article numbere20230056
JournalJornal Vascular Brasileiro
Volume22
DOIs
StatePublished - 2023
Externally publishedYes

Keywords

  • acute pulmonary embolism
  • direct oral anticoagulants
  • morbid obesity
  • rivaroxaban
  • venous thromboembolism

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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