Dabigatran-induced acute hepatitis in a patient with atrial fibrillation: a rare case report
Abstract
Background: Dabigatran etexilate is a prodrug converted into active dabigatran, a reversible thrombin inhibitor, after oral administration. The Food and Drug Administration approved it for stroke prevention in non-valvular atrial fibrillation patients and for treating deep venous thrombosis and pulmonary embolism. In the Randomized Evaluation of Long-Term Anticoagulation Therapy trial, dabigatran demonstrated non-inferior efficacy and reduced haemorrhagic stroke risk compared with warfarin. Herein, we present a rare case of a patient with atrial fibrillation who developed acute hepatitis following dabigatran initiation.
Case summary: A 69-year-old man with a history of hypertension, diabetes, and recent non-ST elevation acute coronary syndrome underwent drug-eluting stent placement in October 2024. He was discharged on antiplatelets, heart failure, and diabetes therapies. On 12 November 2024, dabigatran 110 mg twice daily was added for atrial fibrillation stroke prevention, discontinuing aspirin. Two weeks later, the patient presented with decreased appetite, epigastric discomfort, dark urine, weight loss, and constipation. Laboratory tests revealed elevated hepatic enzymes, excluding viral and other aetiologies. After discontinuing dabigatran, the liver enzymes normalized during hospitalization. He was discharged on 11 December 2024, and his anticoagulant was switched to edoxaban during the follow-up visit a week later. Liver function remained normal since then.
Discussion:…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
Read the paper
Related studies
- The Role of AMPK Activation for Cardioprotection in Doxorubicin-Induced Cardiotoxicity
- Hypoglycemic medicines in the treatment of Alzheimer’s disease: Pathophysiological links between AD and glucose metabolism
- Isorhamnetin Reduces Glucose Level, Inflammation, and Oxidative Stress in High-Fat Diet/Streptozotocin Diabetic Mice Model
- Modulating Sirtuin Biology and Nicotinamide Adenine Diphosphate Metabolism in Cardiovascular Disease—From Bench to Bedside
- Characterization of the SGLT2 Interaction Network and Its Regulation by SGLT2 Inhibitors: A Bioinformatic Analysis
- Early Treatment with Empagliflozin and GABA Improves β-Cell Mass and Glucose Tolerance in Streptozotocin-Treated Mice
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.