Argatroban therapy in patients with coronary artery disease and heparin-induced thrombocytopenia.
The efficacy of the direct thrombin inhibitor argatroban was investigated in patients who developed heparin-induced thrombocytopenia following heparin therapy for coronary artery disease. The outcome of 121 patients treated with argatroban was compared with that of 26 patients in a historical control (i.e. patients who did not receive direct thrombin inhibition therapy). Argatroban, compared with controls, significantly reduced the 37-day composite of death, amputation or new thrombosis (30 versus 50%, p = 0.043), primarily driven by a significant decrease in new thrombosis (10 versus 31%, p = 0.01), and led to less bleeding (4 versus 15%, p = 0.046). Therefore, in patients with coronary artery disease who develop heparin-induced thrombocytopenia, argatroban provides safe, effective anticoagulation.
Jang
Ik-Kyung
IK
Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
Hursting
Marcie J
MJ
McCollum
David
D
D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D000925:Anticoagulants / Q000627:therapeutic use*; D001120:Arginine / Q000031:analogs & derivatives; D016022:Case-Control Studies; D002423:Cause of Death; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010875:Pipecolic Acids / Q000627:therapeutic use*; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy* / Q000401:mortality; D016896:Treatment Outcome
D000925:Anticoagulants; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban