title: Percutaneous coronary interventions in patients with heparin-induced thrombocytopenia.
abstract: 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.
authors: Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA.
authors: E Marc
authors: EM
authors: Jolicoeur
authors: Tracy
authors: T
authors: Wang
authors: Renato D
authors: RD
authors: Lopes
authors: E Magnus
authors: EM
authors: Ohman
mesh_terms: 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
chemical_list: 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