Comparison of argatroban and fondaparinux for the management of patients with isolated heparin-induced thrombocytopenia
| Autor: | Mark Crowther, Fahad A.S. Al-Eidan, Saud Alrawkan, Huda Alshammary |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
030204 cardiovascular system & hematology Arginine Fondaparinux Argatroban 03 medical and health sciences 0302 clinical medicine Thromboembolism Internal medicine Heparin-induced thrombocytopenia medicine Humans Prospective cohort study Aged Retrospective Studies Sulfonamides Heparin business.industry 030208 emergency & critical care medicine Retrospective cohort study Hematology General Medicine Middle Aged medicine.disease Thrombocytopenia Pipecolic Acids Cohort Complication business medicine.drug |
| Zdroj: | Annals of Hematology. 97:2055-2059 |
| ISSN: | 1432-0584 0939-5555 |
| DOI: | 10.1007/s00277-018-3422-6 |
| Popis: | Heparin-induced thrombocytopenia (HIT) is a serious complication of the administration of heparin and its derivatives. Non-heparin anticoagulants such as argatroban and fondaparinux are widely used in the management of HIT to compare the effectiveness of argatroban and fondaparinux in the resolution of thrombocytopenia and to compare clinical outcomes in patients with isolated HIT. A retrospective cohort analysis was performed at King Abdulaziz Medical City (KAMC) on patients diagnosed with isolated HIT between 31 Jan, 2014 and 30 June, 2017. Demographics data, non-heparin anticoagulants, related laboratory results, and clinical outcomes were retrieved and analysed. The cohort comprised a total of 95 adult patients who received either argatroban (56 patients) or fondaparinux (39 patients) for isolated HIT. The median age and sex distribution were similar in both argatroban and fondaparinux groups. The mean (+ SD) time (in days) for the resolution of thrombocytopenia was 3.5 (± 1.8) for patients who received argatroban and 3.7 (± 1.7) for patients administered fondaparinux (p = 0.843). Thromboembolic events occurred in five patients (8.9%) administered argatroban and in three patients (7.7%) administered fondaparinux (p = 0.382). There was no significant difference in the rates of bleeding or death (p = 0.829); however, the small number of cases limits our ability to draw conclusions about these outcomes. In this retrospective study, fondaparinux and argatroban were similarly effective in resolving thrombocytopenia, preventing further thromboembolic events, and maintaining safety in patients with confirmed HIT. To confirm this observation, larger prospective studies are needed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink