Anticoagulation for acute coronary syndromes and percutaneous coronary intervention in patients with heparin-induced thrombocytopenia.
Heparin-induced thrombocytopenia (HIT) is not uncommon in clinical practice, and may go unrecognized in a substantial number of patients. The pathophysiology of HIT has only recently been better understood. Patients with HIT may require anticoagulation for thrombotic complications that result in severe morbidity and mortality. These patients may also require anticoagulation for acute coronary syndromes (ACS), or during percutaneous coronary interventions (PCIs). The direct thrombin inhibitors are currently the anticoagulant of choice in HIT patients with ACS or those undergoing PCI, based on data from several large clinical trials in ACS and PCI populations, and data from smaller experiences, specifically in patients with HIT.
Mahaffey
K W
KW
Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA. mahaf002@mc.duke.edu
D000721:Ancrod / Q000627:therapeutic use; D000789:Angina, Unstable / Q000188:drug therapy*; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D000991:Antithrombins / Q000627:therapeutic use; D006493:Heparin / Q000009:adverse effects*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006496:Heparinoids / Q000627:therapeutic use; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy* / Q000503:physiopathology
D000925:Anticoagulants; D000991:Antithrombins; D006495:Heparin, Low-Molecular-Weight; D006496:Heparinoids; D010975:Platelet Aggregation Inhibitors; D006493:Heparin; D000721:Ancrod