Department of Internal Medicine I, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Kollarova 2, 036 59, Martin, Slovak Republic.
National Centre of Hemostasis and Thrombosis, Department of Hematology and Blood Transfusion, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, Martin, Slovak Republic.
J Thromb Thrombolysis. 2019 Nov;48(4):619-622. doi: 10.1007/s11239-019-01910-0.
Very limited but promising experiences with the use of direct factor Xa inhibitors for the treatment of heparin-induced thrombocytopenia (HIT) have been reported. This contribution features our first experience with the use of apixaban (without a pre-treatment with parenteral anticoagulant) to treat a case of HIT which developed in a patient after multiple heart replacement surgery. Apixaban was effective, well tolerated and safe. An apixaban-calibrated chromogenic anti-Xa activity assessment was used to monitor apixaban activity throughout the therapy. Patient continued on apixaban for the prevention of thrombosis in the settings of atrial fibrillation. No ischemic or bleeding events occurred during the clinical follow up and the platelet count was stable. Our experience suggests that apixaban might be effectively used for the treatment of HIT and for the long-term prevention of embolism in patients after multiple valve replacement with biological prostheses and atrial fibrillation.
已有关于使用直接因子 Xa 抑制剂治疗肝素诱导的血小板减少症（HIT）的有限但有前景的经验报道。本研究首次报道了我们使用阿哌沙班（无预先使用静脉抗凝剂）治疗心脏多次置换手术后发生 HIT 的病例的经验。阿哌沙班治疗有效，耐受性良好且安全。在整个治疗过程中，我们使用了阿哌沙班校准的显色抗 Xa 活性评估来监测阿哌沙班的活性。患者继续服用阿哌沙班以预防心房颤动时的血栓形成。在临床随访期间未发生缺血或出血事件，血小板计数稳定。我们的经验表明，阿哌沙班可能有效用于治疗 HIT 以及预防多次生物瓣置换和心房颤动后患者的栓塞。
