Percutaneous coronary interventions in patients with heparin-induced thrombocytopenia.
Accomplishing a successful percutaneous coronary intervention in a patient with a suspected or diagnosed heparin-induced thrombocytopenia (HIT) requires the selection of an appropriate alternative anticoagulant and a thorough assessment of bleeding and thrombotic risks. In this review, we suggest an evidence-based management algorithm that takes into account the clinical phase of HIT (acute, recent, and remote HIT) and the associated risk when patients present with acute coronary syndrome. The algorithm also integrates preventive measures directed at decreasing the bleeding risk associated with the antithrombotic and invasive therapies used for HIT and percutaneous coronary intervention.
Jolicoeur
E Marc
EM
Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA.
Wang
Tracy
T
Lopes
Renato D
RD
Ohman
E Magnus
EM
D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D001120:Arginine / Q000031:analogs & derivatives; D002809:Chondroitin Sulfates / Q000627:therapeutic use; D015897:Comorbidity; D003871:Dermatan Sulfate / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D000077425:Fondaparinux; D006493:Heparin / Q000009:adverse effects*; D006496:Heparinoids / Q000627:therapeutic use; D006497:Heparan Sulfate / Q000627:therapeutic use; D006629:Hirudins; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy*; D010446:Peptide Fragments / Q000627:therapeutic use; D010875:Pipecolic Acids / Q000627:therapeutic use; D011134:Polysaccharides / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000627:therapeutic use; D013449:Sulfonamides; D013577:Syndrome; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000453:epidemiology*; D014812:Vitamin K / Q000037:antagonists & inhibitors
D000925:Anticoagulants; D001120:Arginine; D002809:Chondroitin Sulfates; D003871:Dermatan Sulfate; D005343:Fibrinolytic Agents; D000077425:Fondaparinux; D006493:Heparin; D006496:Heparinoids; D006497:Heparan Sulfate; D006629:Hirudins; D010446:Peptide Fragments; D010875:Pipecolic Acids; D011134:Polysaccharides; D011994:Recombinant Proteins; D013449:Sulfonamides; D014812:Vitamin K; C035838:danaparoid; C031942:argatroban; C074619:bivalirudin