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Heparin-induced Thrombocytopenia: Pathophysiology, Diagnosis, and Review of Pharmacotherapy

Cardiology Department, Saint Vincent Hospital, Worcester, Massachusetts, Massachusetts College of Pharmacy and Health Sciences, Worcester, Massachusetts, Abir.Kanaan{at}mcphs.edu

A. Samer Al-Homsi, MD

University of Massachusetts Medical Center, and University of Massachusetts Medical School, Worcester, Massachusetts

Heparin-induced thrombocytopenia is an adverse drug reaction to heparin therapy leading to devastating clinical outcomes including venous thromboembolism, myocardial infarction, stroke, and limb amputation. Heparin cessation alone is not sufficient for the management of heparin-induced thrombocytopenia. Direct thrombin inhibitors, such as argatroban and lepirudin, are considered the mainstay for the management of heparin-induced thrombocytopenia. Case reports support the use of fondaparinux in the management of heparin-induced thrombocytopenia; however, randomized trials are still lacking. This article will review the pathophysiology, clinical presentation, complications, diagnosis, and pharmacotherapy management of heparin-induced thrombocytopenia.

Key Words: Heparin-induced thrombocytopenia • HIT • direct thrombin inhibitors • argatroban • lepirudin

This version was published on April 1, 2009

Journal of Pharmacy Practice, Vol. 22, No. 2, 149-157 (2009)
DOI: 10.1177/0897190008326445


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