Treatment of Heparin-Induced Thrombocytopenia When Percutaneous Coronary Intervention Is Required
Patients presenting with acute HIT or subacute HIT A who simultaneously require percutaneous coronary intervention (PCI) represent a distinct clinical scenario in which careful selection of a non-heparin anticoagulant is essential.
Clinical scenario
Acute HIT or subacute HIT A with a concurrent requirement for percutaneous coronary intervention.
Treatment approach
Evidence-based guidance identifies a preferred non-heparin anticoagulant for use in this setting, with a recognised alternative for circumstances where the preferred agent is unavailable or institutional experience is limited. The complete selection criteria and regimen details are in the full protocol.
References
DOI: 10.1182/bloodadvances.2018024489
- In patients with acute HIT or subacute HIT A who require PCI, the ASH guideline panel suggests treatment with bivalirudin rather than a different non-heparin anticoagulant (conditional recommendation, low certainty in the evidence).
- If bivalirudin is not available or there is a lack of institutional experience, argatroban might be a suitable substitute.