Hirudin-based anticoagulant strategies for patients with suspected heparin-induced thrombocytopenia undergoing percutaneous coronary interventions and bypass grafting

被引:11
作者
Becker, RC [1 ]
机构
[1] Univ Massachusetts, Sch Med, UMass Mem Med Ctr, Cardiovasc Thrombosis Res Ctr, Worcester, MA 01655 USA
关键词
heparin-induced thrombocytomis; hiruden; revascularization;
D O I
10.1023/A:1027385304093
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Heparin-induced thrombocytopenia (HIT) is an immune-mediated adverse drug reaction that is associated with thrombotic events of the venous and arterial circulatory systems stemming from an intense and well-characterized prothrombotic triad of platelet activation, coagulation cascade stimulation and vascular endothelial cell injury. Although heparin (or other sulfated mucopolysaccharide compound) cessation represents a vital first step in management, patients remain susceptible to life-threatening thrombosis for up to several weeks, providing a strong rationale for a 'proactive approach' to care that includes prompt initiation of an alternative anticoagulant strategy throughout the high-risk period. The importance of alternative options for anticoagulation is most evident in clinical situations wherein treatment is a recognized standard of care and prerequisite for an optimal outcome. The following review highlights the use of recombinant hirudin (lepirudin) among patients with suspected HIT requiring precutaneous coronary interventions (PCI) and coronary arterial bypass grafting.
引用
收藏
页码:S59 / S68
页数:10
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