{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:06:12Z","timestamp":1779206772077,"version":"3.51.4"},"reference-count":52,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,12,29]],"date-time":"2020-12-29T00:00:00Z","timestamp":1609200000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>It is unclear if stopping treatment with dabigatran, a new oral anticoagulant (NOAC), induces a paradoxical rebound prothrombotic state. We investigated if short\u2010term (1\u20133\u2009days) dabigatran cessation is associated with a higher thrombus volume than expected from a simple reversal of the anticoagulant effect.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ten\u2010week\u2010old C57Bl\/6 mice (n = 338) received one of the following oral treatments: phosphate\u2010buffered saline (PBS), dabigatran for 7\u2009days with or without 1 to 4\u2009day cessation, and aspirin in either a single dose or daily for 7\u2009days. Some of the animals that ceased dabigatran for 1 to 3\u2009days received single\u2010dose aspirin. Thereafter, we induced FeCl<jats:sub>3<\/jats:sub>\u2010mediated carotid thrombosis in 130 mice, after which we performed micro computed tomography thrombus imaging. The other 208 mice underwent coagulation assays or platelet function tests. As an explorative pilot study, we reviewed the medical records of 18 consecutive patients with NOAC cessation\u2010related cerebral infarction in a large acute stroke cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed a ~ 40% higher volume of carotid thrombus after dabigatran cessation at 1 to 3\u2009days than after vehicle treatment and showed that this effect could be prevented by single\u2010dose aspirin pretreatment. Dabigatran cessation unduly increased platelet aggregability for 2\u2009days after drug cessation, an effect mediated through thrombin or arachidonic acid, which effect was significantly attenuated by single\u2010dose aspirin pretreatment. In patients, short\u2010term (\u2264\u20093\u2009days) cessation of NOAC therapy, compared with longer\u2010term (\u2265\u20095\u2009days) cessation, tended to be associated with relatively high stroke severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>We provide the first preclinical evidence that a rebound prothrombotic state follows short\u2010term cessation of dabigatran therapy. ANN NEUROL 2021;89:444\u2013458<\/jats:p><\/jats:sec>","DOI":"10.1002\/ana.25964","type":"journal-article","created":{"date-parts":[[2020,11,21]],"date-time":"2020-11-21T09:09:24Z","timestamp":1605949764000},"page":"444-458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Short\u2010Term Cessation of Dabigatran Causes a Paradoxical Prothrombotic State"],"prefix":"10.1002","volume":"89","author":[{"given":"Jiwon","family":"Kim","sequence":"first","affiliation":[{"name":"Molecular Imaging and Neurovascular Research Laboratory, Department of Neurology Dongguk University College of Medicine  Goyang Republic of Korea"},{"name":"Department of Medicine Dongguk University  Seoul Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hee Jeong","family":"Jang","sequence":"additional","affiliation":[{"name":"Molecular Imaging and Neurovascular Research Laboratory, Department of Neurology Dongguk University College of Medicine  Goyang Republic of Korea"},{"name":"Department of Medical Biotechnology Dongguk University  Goyang Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawid","family":"Schellingerhout","sequence":"additional","affiliation":[{"name":"Departments of Diagnostic Radiology and Cancer Systems Imaging University of Texas M. 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