Use of lepirudin during percutaneous vascular interventions in patients with heparin-induced thrombocytopenia.
Research article published in The Journal of invasive cardiology (2003)
Abstract
UNLABELLED: Heparin-induced thrombocytopenia (HIT) is a well-known complication of heparin exposure and presents a clinical dilemma for patients undergoing percutaneous intervention (PI). Heparin cannot be used for thrombin inhibition and direct thrombin inhibitors offer an attractive alternative to heparin. We report our experience with lepirudin, a recombinant hirudin, used for PI in HIT patients. METHODS: Patients undergoing PI with known diagnosis of HIT were assigned to varying doses of lepirudin, often in combination with a platelet glycoprotein (GP) IIb/IIIa inhibitor. Predetermined endpoints of safety and efficacy were assessed prospectively. RESULTS: Twenty-five patients underwent a total of 36 interventions. Angiographic success was obtained in 100% of patients and clinical success (freedom from death, myocardial infarction, stroke or target vessel revascularization) in 92% of patients. There was 1 procedure-related mortality resulting from a retroperitoneal bleed. Three patients had minor bleeding. CONCLUSION: Lepirudin is efficacious as a replacement for heparin in patients with HIT undergoing PI. Caution should be used when using a combination of lepirudin, GP IIb/IIIa inhibitors, clopidogrel and aspirin.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Use of lepirudin during percutaneous vascular interventions in patients with heparin-induced thrombocytopenia.
Por qué esto importa para la hirudoterapia
Este estudio prospectivo reportó la experiencia con el uso de lepirudina (hirudina recombinante) como sustituto de la heparina en 25 pacientes con trombocitopenia inducida por heparina sometidos a 36 intervenciones vasculares percutáneas, frecuentemente combinadas con inhibidores de GP IIb/IIIa, alcanzando un éxito angiográfico del 100 % y un éxito clínico del 92 %, con una mortalidad relacionada con el procedimiento debida a hemorragia retroperitoneal y tres eventos hemorrágicos menores. Directamente relevante para la ASH como aplicación clínica de un anticoagulante derivado de la sanguijuela en cardiología intervencionista. Advertencia: tamaño muestral pequeño sin un grupo control concurrente, y los autores llaman la atención sobre el riesgo hemorrágico al combinar lepirudina con múltiples antiagregantes plaquetarios; el estudio se refiere a la hirudina recombinante farmacéutica y no a la terapia con sanguijuelas vivas.
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026