Argatroban in the management of heparin-induced thrombocytopenia: a multicenter clinical trial - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Critical Care Année : 2015

Argatroban in the management of heparin-induced thrombocytopenia: a multicenter clinical trial

Résumé

Introduction: 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. Mrthods: 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. Results: 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. Conclusion:onsidering 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.

Domaines

Hématologie
Fichier principal
Vignette du fichier
Argatroban in the management of heparin-induced thrombocytopenia_ a multicenter clinical trial.pdf (555.48 Ko) Télécharger le fichier
Origine : Publication financée par une institution
Loading...

Dates et versions

hal-01479771 , version 1 (15-03-2019)

Licence

Paternité

Identifiants

Citer

Brigitte Tardy-Poncet, Philippe Nguyen, Jean-Claude Thiranos, Pierre-Emmanuel Morange, Christine Biron-Andréani, et al.. Argatroban in the management of heparin-induced thrombocytopenia: a multicenter clinical trial. Critical Care, 2015, 19, pp.396. ⟨10.1186/s13054-015-1109-0⟩. ⟨hal-01479771⟩
114 Consultations
76 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More