Document Detail


Efficacy and safety of argatroban in patients with heparin induced thrombocytopenia undergoing endovascular intervention for peripheral arterial disease.
MedLine Citation:
PMID:  18546237     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: This study aimed to evaluate the efficacy and safety of argatroban during percutaneous interventions for peripheral arterial disease (PAD). BACKGROUND: Endovascular interventions are commonly used in patients with peripheral arterial disease. Heparin is routinely administered during these procedures, but cannot be used in patients with a history of heparin-induced thrombocytopenia (HIT). Argatroban is an approved direct thrombin inhibitor for treatment of patients with HIT. There are currently few data on the efficacy and safety of argatroban during endovascular interventions for PAD. METHODS: Patients who underwent endovascular interventions for PAD on argatroban between 2002 and 2005 were identified from out database. Efficacy was evaluated using a composite of death, urgent revascularization, and amputation, while safety was assessed by TIMI major bleeding during the index hospitalization. RESULTS: A total of 48 patients undergoing lower extremity revascularization on argatroban were identified. Thirty two of these patients (67%) had antibody-confirmed HIT and the other 16 (33%) had suspected HIT. A mean dose of argatroban was 173.5 +/- 143 microg/kg bolus, followed by a 10.7 +/- 9.64 microg/kg/min infusion during the procedure. Twelve patients (25%) met the composite end point (two deaths, one urgent revascularization, nine amputations because of progressive peripheral arterial disease). TIMI major bleeding occurred in three (6%) patients. CONCLUSION: In patients with confirmed or suspected HIT undergoing endovascular intervention for PAD, argatroban appears to be effective and safe. A larger study is warranted to confirm these findings from a single center.
Authors:
Suzanne J Baron; Robert W Yeh; Ignacio Cruz-Gonzalez; Josephine L Healy; Eugene Pomerantsev; Joseph Garasic; Douglas Drachman; Kenneth Rosenfield; Ik-Kyung Jang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  72     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2008 Jul 
Date Detail:
Created Date:  2008-06-23     Completed Date:  2008-10-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  116-20     Citation Subset:  IM    
Copyright Information:
(c) 2008 Wiley-Liss, Inc.
Affiliation:
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty*
Anticoagulants / therapeutic use*
Female
Heparin / adverse effects
Humans
Male
Middle Aged
Peripheral Vascular Diseases / complications*,  therapy*
Pipecolic Acids / therapeutic use*
Retrospective Studies
Thrombocytopenia / chemically induced,  complications*,  therapy
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Pipecolic Acids; 74863-84-6/argatroban; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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