Seminars in thrombosis and hemostasis
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Semin. Thromb. Hemost. · Jan 1999
Use of argatroban during percutaneous coronary interventions in patients with heparin-induced thrombocytopenia.
Percutaneous coronary revascularization (PTCR) procedures require intense anticoagulation during the procedure to reduce the risk of a thrombotic complication. This anticoagulation is almost always performed with unfractionated heparin. Heparin, however, is far from the ideal anticoagulant for use in PTCR, and its use is contraindicated in patients with known or suspected heparin-induced thrombocytopenia (HIT) or the heparin-induced thrombocytopenia and thrombosis syndrome (HITTS). ⋯ Argatroban was used in a trial of 50 patients with known or suspected HIT or HITTS who required PTCR. Adequate anticoagulation was achieved in 98% and there was procedural success in 98% with only 1 major bleeding event. These preliminary data suggest that argatroban can be used safely and effectively as an anticoagulant during PTCR in patients with known or suspected HIT or HITTS.