Title |
Argatroban in the management of heparin-induced thrombocytopenia: a multicenter clinical trial
|
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Published in |
Critical Care, December 2015
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DOI | 10.1186/s13054-015-1109-0 |
Pubmed ID | |
Authors |
Brigitte Tardy-Poncet, Philippe Nguyen, Jean-Claude Thiranos, Pierre-Emmanuel Morange, Christine Biron-Andréani, Yves Gruel, Jérome Morel, Alain Wynckel, Lelia Grunebaum, Judith Villacorta-Torres, Sandrine Grosjean, Emmanuel de Maistre |
Abstract |
The aim of this study was to collect data in France in patients with heparin-induced thrombocytopenia who required parenteral anticoagulation and for whom other non-heparin anticoagulant therapies were contraindicated including patients with renal failure, cross-reactivity to danaparoid or at high hemorrhagic risk. A total of 20 patients, of mean age 72 ± 10 years, were enrolled in this open-label, multicenter clinical study. Exploratory statistical data analysis was performed with descriptive interpretation of intra-individual comparisons using simple univariate statistics. The diagnosis of HIT was confirmed in 16 subjects by an independent scientific committee. Fourteen patients (70 %) were in an intensive care unit during the course of the study. Patients were treated with argatroban for a mean duration of 8.5 ± 6.1 days. The mean starting dose of argatroban was 0.77 ± 0.45 μg/kg/min. Platelet recovery was rapid. aPTT and anti-IIa activity assays were used to monitor the dose of argatroban. The mean baseline aPTT value was 45.0 ± 9.8 sec and increased to 78.2 ± 35.8 sec two hours after initiating argatroban. At this time mean argatroban concentration was 0.34 ± 0.16 and 0.61 ± 0.28 μg/ml using ECT and TT measurements, respectively. New and/or extended thromboses were reported in 25 % of patients and major bleedings were documented in 15 %. Six patients died due to their underlying medical condition. Considering its hepatic elimination and its short half-life, argatroban can be considered as a safe therapeutic option in HIT patients at high hemorrhagic risk and with renal failure, particularly in an ICU setting. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 4 | 14% |
United States | 4 | 14% |
France | 1 | 4% |
Spain | 1 | 4% |
Costa Rica | 1 | 4% |
Canada | 1 | 4% |
Mexico | 1 | 4% |
Switzerland | 1 | 4% |
Germany | 1 | 4% |
Other | 2 | 7% |
Unknown | 11 | 39% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 15 | 54% |
Practitioners (doctors, other healthcare professionals) | 10 | 36% |
Science communicators (journalists, bloggers, editors) | 2 | 7% |
Scientists | 1 | 4% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
France | 2 | 4% |
Japan | 1 | 2% |
Unknown | 51 | 94% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Other | 9 | 17% |
Student > Bachelor | 6 | 11% |
Researcher | 6 | 11% |
Student > Master | 6 | 11% |
Student > Ph. D. Student | 4 | 7% |
Other | 10 | 19% |
Unknown | 13 | 24% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 22 | 41% |
Pharmacology, Toxicology and Pharmaceutical Science | 4 | 7% |
Biochemistry, Genetics and Molecular Biology | 4 | 7% |
Chemistry | 2 | 4% |
Agricultural and Biological Sciences | 1 | 2% |
Other | 4 | 7% |
Unknown | 17 | 31% |