Argatroban use in heparin-induced thrombocytopenia.
BACKGROUND
Heparin-induced thrombocytopenia (HIT) is a serious, life-threatening complication which occurs in 1-3% of patients receiving heparin. Patients with untreated HIT have an up to 50% risk of developing life- and limb-threatening thromboembolic complications. Treatment is based upon clinical suspicion, stopping heparin therapy and initiation of anticoagulation with a rapidly acting alternative non-heparin anticoagulant, such as argatroban-a hepatically excreted direct thrombin inhibitor which is effective in the treatment of HIT.


OBJECTIVE
To summarize the pharmacological and clinical data, and discuss the impact of argatroban in the current treatment of HIT.


METHODS
A literature search was performed with the aid of Pubmed and Google. Search parameters of 'argatroban', 'heparin-induced thrombocytopenia' and 'treatment' were input into both search engines.


CONCLUSIONS
Argatroban is a safe and effective treatment for HIT. In patients taking other hepatically cleared medications, lower initial doses may have to be used to avoid over-anticoagulation.
Boggio
Lisa N
LN
Rush University Medical Center, The RUSH Hemophilia and Thrombophilia Center, 1725 W Harrison Street, Suite 809, Chicago, Illinois 60612, USA. Lisa_Boggio@rush.edu
Oza
Veeral M
VM
D000925:Anticoagulants / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001120:Arginine / Q000031:analogs & derivatives; D002986:Clinical Trials as Topic; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000378:metabolism; D010875:Pipecolic Acids / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D013449:Sulfonamides; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control
D000925:Anticoagulants; D010875:Pipecolic Acids; D013449:Sulfonamides; D006493:Heparin; D001120:Arginine; C031942:argatroban