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.

CONCLUSION

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.