Argatroban use in heparin-induced thrombocytopenia

Abstract

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.