Jolicoeur E Marc, Wang Tracy, Lopes Renato D, Ohman E Magnus
Duke Clinical Research Institute, Duke University Medical Center, Durham, NC 27710, USA.
Curr Cardiol Rep. 2007 Sep;9(5):396-405. doi: 10.1007/BF02938367.
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.
对于疑似或确诊肝素诱导的血小板减少症（HIT）的患者，要成功实施经皮冠状动脉介入治疗，需要选择合适的替代抗凝剂，并全面评估出血和血栓形成风险。在本综述中，我们提出一种基于证据的管理算法，该算法考虑了HIT的临床阶段（急性、近期和远期HIT）以及患者出现急性冠状动脉综合征时的相关风险。该算法还整合了旨在降低与用于HIT和经皮冠状动脉介入治疗的抗栓和侵入性治疗相关出血风险的预防措施。
