Source:http://linkedlifedata.com/resource/pubmed/id/19057393
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
6
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| pubmed:dateCreated |
2008-12-22
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| pubmed:abstractText |
We retrospectively characterized major bleeding events and their risk factors among 269 patients with clinically diagnosed heparin-induced thrombocytopenia (HIT) treated using argatroban (2 microg x kg(-1) x min(-1) initially, adjusted to achieve activated partial thromboplastin times (aPTTs) 1.5-3 times the baseline) in a prospective multicenter study. Patients received a median (range) dose of 1.9 (0.2-9.7) microg x kg(-1) x min(-1) for 5.6 (0.1-61) days. Average aPTTs during therapy were 61.6 (37-183) seconds. Major bleeding, most commonly gastrointestinal, occurred in 19 patients (7.1%) during therapy. Another patient suffered from intracranial hemorrhage 4 days after argatroban cessation. Bleeding was fatal in 2 patients (0.7%); each received multiple anticoagulants and thrombolytic therapy. Major bleeding was more likely to occur in patients with HIT-related thrombosis (odds ratio = 2.9, P = 0.039), pulmonary impairment (odds ratio = 20.3, P < 0.001), or an aPTT >100 seconds (odds ratio = 3.7, P = 0.010). Major bleeding rates associated with average aPTTs of <45, 45-67.5, 67.6-90, and >90 seconds, respectively, were 5.0% (1 of 20 patients), 5.6% (9 of 162 patients), 8.7% (6 of 69 patients), and 22% (4 of 18 patients). No significant effect of patient demographics, other baseline illnesses including hepatic or renal impairment, argatroban dose, or treatment duration was detected on major bleeding. Risk factors for major bleeding in argatroban-treated patients with HIT include baseline HIT-related thrombosis and pulmonary impairment. For minimizing bleeding risk during argatroban therapy for HIT, the aPTT should be routinely monitored and maintained at <90 seconds.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:chemical | |
| pubmed:status |
MEDLINE
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| pubmed:month |
Dec
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| pubmed:issn |
1533-4023
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| pubmed:author | |
| pubmed:issnType |
Electronic
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| pubmed:volume |
52
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
561-6
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| pubmed:meshHeading |
pubmed-meshheading:19057393-Adolescent,
pubmed-meshheading:19057393-Adult,
pubmed-meshheading:19057393-Aged,
pubmed-meshheading:19057393-Aged, 80 and over,
pubmed-meshheading:19057393-Anticoagulants,
pubmed-meshheading:19057393-Blood Coagulation,
pubmed-meshheading:19057393-Drug Monitoring,
pubmed-meshheading:19057393-Female,
pubmed-meshheading:19057393-Hemorrhage,
pubmed-meshheading:19057393-Heparin,
pubmed-meshheading:19057393-Humans,
pubmed-meshheading:19057393-Lung Diseases,
pubmed-meshheading:19057393-Male,
pubmed-meshheading:19057393-Middle Aged,
pubmed-meshheading:19057393-Odds Ratio,
pubmed-meshheading:19057393-Partial Thromboplastin Time,
pubmed-meshheading:19057393-Pipecolic Acids,
pubmed-meshheading:19057393-Retrospective Studies,
pubmed-meshheading:19057393-Risk Assessment,
pubmed-meshheading:19057393-Risk Factors,
pubmed-meshheading:19057393-Thrombocytopenia,
pubmed-meshheading:19057393-Thrombosis,
pubmed-meshheading:19057393-Young Adult
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| pubmed:year |
2008
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| pubmed:articleTitle |
Risk factors for major bleeding in patients with heparin-induced thrombocytopenia treated with argatroban: a retrospective study.
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| pubmed:affiliation |
Clinical Science Consulting, Austin, TX, USA.
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| pubmed:publicationType |
Journal Article
|