Treatment of heparin-induced thrombocytopenia in cardiovascular patients

Heparin-induced thrombocytopenia (HIT) is an antibody-mediated syndrome associated with heparin exposure, a falling platelet count and a high risk of thrombosis. Cardiovascular patients are at increased risk of HIT due to wide use of heparin in this population. Should HIT be suspected, heparin must be avoided in most situations, and anticoagulation with an alternative anticoagulant should be instituted. Preferred agents include the direct thrombin inhibitors argatroban and lepirudin, whilst bivalirudin or desirudin (other direct thrombin inhibitors) can be used in some situations. The indirect thrombin inhibitors, danaparoid and fondaparinux, can also be considered at times. These agents and their use in cardiac patients, including patients with acute coronary syndrome, percutaneous coronary interventions, acute ST elevation myocardial infarction or cardiac surgery, will be reviewed.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

This review covers non-heparin anticoagulants for cardiovascular patients with heparin-induced thrombocytopenia, naming the direct thrombin inhibitors argatroban and lepirudin as preferred agents, with bivalirudin or desirudin usable in some situations and danaparoid or fondaparinux also considered.

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