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Title of Journal: J Thromb Thrombolysis

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Abbravation: Journal of Thrombosis and Thrombolysis

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Springer US

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DOI

10.1016/0043-1354(92)90200-n

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1573-742X

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A comparison of direct thrombin inhibitors in the

Authors: Karen M Curzio A ChengLai V Kheyfets M Sinnet H H Billett
Publish Date: 2008/09/25
Volume: 28, Issue: 2, Pages: 117-123
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Abstract

Background and objective HeparinInduced Thrombocytopenia HIT if left untreated can lead to thrombocytopenia thromboembolic complications and even death Two thrombin inhibitors lepirudin and argatroban have been shown to improve clinical outcomes compared to historical controls in the management of HIT The purpose of this retrospective study was to compare the effects of lepirudin and argatroban in the management of HIT Methods Adult subjects with a positive antiheparin platelet factor 4 PF4 antibody test and 50 decrease in platelet count during the first 30 days of admission over a period of 2 years were included in the study Patient demographics platelet counts choice of antithrombin therapy occurrence of thrombosis length of hospital stay and date and cause of death if applicable were collected for each patient Results Eightytwo patients met inclusion criteria 41 patients did not receive any thrombin inhibitors after the diagnosis of HIT 24 patients received lepirudin and 17 patients received argatroban Subjects treated with a thrombin inhibitor were more likely to experience platelet count recovery 875 for the lepirudin group and 824 for the argatroban group compared to those who did not receive antithrombin therapy 512 after the diagnosis of HIT was made P  0001 The thrombosis rate for subjects who did not receive antithrombin therapy after the diagnosis of HIT was 268 compared to 83 for the lepirudin group and 59 for the argatroban group P  001 The incidence of death was also higher in the group of subjects that did not receive antithrombin therapy 488 compared with the lepirudin group 167 or the argatroban group 235 P  001 Conclusion Our findings suggest that thrombin inhibitors can improve the outcomes of patients with HIT by decreasing the incidence of morbidity and mortality relating to HIT No significant difference could be determined in outcomes between argatroban and lepirudin therapy

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