{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:53:00Z","timestamp":1777859580907,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T00:00:00Z","timestamp":1727136000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    The purpose of this case report is to describe a case of switching warfarin to apixaban in a patient on anticoagulant prophylaxis for a patent foramen ovale (PFO)-associated stroke.\n                    <jats:bold>Case Summary:<\/jats:bold>\n                    An 86-year-old Afro-Latina female with a past medical history of cerebrovascular accident (CVA) in 2012 secondary to PFO and diagnosed Atrial Fibrillation (AF). Patient was switched from warfarin to apixaban after 3\u00a0months of labile international normalized ratio (INR) levels. The patient\u2019s INR was monitored at a pharmacist-led anticoagulation clinic. As the patient\u2019s INR remained subtherapeutic while on warfarin, a shared decision was made to switch the patient to apixaban 2.5\u00a0mg twice daily due to consistently painful enoxaparin injections, inconsistent vitamin K intake, frequent clinic visits and unstable renal function. Patient tolerated the anticoagulant switch well and reported satisfaction with decreased clinic visits and variable vitamin K diet. At 12\u00a0months post-switch, the patient\u2019s complete blood count remains stable, no reported signs and symptoms of bleeding, and no new CVA or venous thromboembolism (VTE) events identified. Based on an improvement in renal function, the dose was increased to 5\u00a0mg twice daily.\n                  <\/jats:p>","DOI":"10.1177\/08971900241287611","type":"journal-article","created":{"date-parts":[[2024,9,24]],"date-time":"2024-09-24T18:39:18Z","timestamp":1727203158000},"page":"347-350","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Apixaban as a Secondary Prophylaxis Agent for Patent Foramen Ovale-Associated Stroke"],"prefix":"10.1177","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5028-0635","authenticated-orcid":false,"given":"Rebecca M.","family":"Khaimova","sequence":"first","affiliation":[{"name":"Northwell Health, New Hyde Park, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuliana","family":"Toderika","sequence":"additional","affiliation":[{"name":"The Arnold &amp; Marie Schwartz College of Pharmacy and Health Sciences, Long Island University, Brooklyn, NY, USA"},{"name":"One Brooklyn Health, Brookdale Hospital Medical Center, Brooklyn, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4798-0891","authenticated-orcid":false,"given":"Justin","family":"Ramnarain","sequence":"additional","affiliation":[{"name":"Northwell Health, New Hyde Park, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudette","family":"Donatien","sequence":"additional","affiliation":[{"name":"One Brooklyn Health, Brookdale Hospital Medical Center, Brooklyn, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,9,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.524371"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.117.008356"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009443"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2022.07.025"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.017559"},{"key":"e_1_3_3_7_2","doi-asserted-by":"crossref","first-page":"e063161","DOI":"10.1136\/bmj-2020-063161","article-title":"Advances in the management of cardioembolic stroke associated with patent foramen ovale","volume":"376","author":"Mac Grory B","year":"2022","unstructured":"Mac Grory B, Ohman EM, Feng W, et al. Advances in the management of cardioembolic stroke associated with patent foramen ovale. BMJ. 2022;376:e063161.","journal-title":"BMJ"},{"key":"e_1_3_3_8_2","volume-title":"Lovenox [package Insert]","unstructured":"Lovenox [package Insert]. Bridgewater, NJ. Sanofi-aventis U.S LLC. https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2009\/020164s083lbl.pdf. Updated July 2009. Accessed October 12, 2023."},{"key":"e_1_3_3_9_2","volume-title":"Xarelto [package Insert]","unstructured":"Xarelto [package Insert]. Titusville, NJ. Janssen Pharmaceuticals, Inc. https:\/\/www.janssenlabels.com\/package-insert\/product-monograph\/prescribing-information\/XARELTO-pi.pdf. Updated February 2023. Accessed October 12, 2023."},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(18)30319-3"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1813959"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1705915"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jccase.2018.08.007"},{"key":"e_1_3_3_14_2","volume-title":"Eliquis [package Insert]","unstructured":"Eliquis [package Insert]. Princeton, NJ. Bristol-Myers Squibb Company. https:\/\/packageinserts.bms.com\/pi\/pi_eliquis.pdf. Updated April 2021. 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