Abstract | OBJECTIVE: METHODS: Data were collected retrospectively from January 1, 2007, to December 31, 2010, from patients tested for antiplatelet factor 4/ heparin antibodies on clinical suspicion of heparin-induced thrombocytopenia after cardiothoracic surgery. We evaluated the use of argatroban as a therapeutic agent for the postoperative treatment of suspected heparin-induced thrombocytopenia by comparing thrombotic and bleeding events, platelet dynamics, antiplatelet factor 4/ heparin antibody titer, and clinical probability score between patients who did and did not receive argatroban. RESULTS: Eighty-seven patients were included; 47 patients (54%) were treated with argatroban, and 40 patients (46%) were not treated with argatroban. There was no association between argatroban therapy and bleeding, mortality, length of stay, or pretreatment thrombotic events. Among all patients, antiplatelet factor 4/ heparin antibody titer and clinical probability score were higher in patients treated with argatroban. CONCLUSIONS: Clinical suspicion of heparin-induced thrombocytopenia as detected by clinical probability score and thrombotic complications should prompt immediate cessation of heparin and initiation of an alternative anticoagulant such as argatroban. The results from this study demonstrate that argatroban should be considered without increased risk for adverse events, including bleeding, in the cardiothoracic intensive care unit after surgery.
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Authors | Linda J Demma, Christopher A Paciullo, Jerrold H Levy |
Journal | The Journal of thoracic and cardiovascular surgery
(J Thorac Cardiovasc Surg)
Vol. 143
Issue 5
Pg. 1213-8
(May 2012)
ISSN: 1097-685X [Electronic] United States |
PMID | 22329977
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Chemical References |
- Antibodies
- Anticoagulants
- Pipecolic Acids
- Sulfonamides
- Platelet Factor 4
- Heparin
- Arginine
- argatroban
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Topics |
- Antibodies
(blood)
- Anticoagulants
(administration & dosage, adverse effects, immunology)
- Arginine
(analogs & derivatives)
- Cardiac Surgical Procedures
(adverse effects)
- Drug Substitution
- Georgia
- Hemorrhage
(chemically induced)
- Heparin
(adverse effects, immunology)
- Humans
- Intensive Care Units
- Pipecolic Acids
(administration & dosage, adverse effects)
- Platelet Factor 4
(immunology)
- Predictive Value of Tests
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Sulfonamides
- Thoracic Surgical Procedures
(adverse effects)
- Thrombocytopenia
(chemically induced, diagnosis, immunology, prevention & control)
- Thrombosis
(chemically induced, immunology, prevention & control)
- Time Factors
- Treatment Outcome
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