Anticoagulant Therapy for Prophylaxis and Treatment of Thrombosis Associated With HeparinInduced Thr

1
Anticoagulant Therapy for Prophylaxis and
Treatment of Thrombosis Associated With
Heparin-Induced Thrombocytopenia
2
Heparin-Induced Thrombocytopenia (HIT)
3
Incidence of HIT
4
Consequences of HIT
5
Cumulative Frequency of Thrombosis
6
Clinical Presentations of HIT
7
Pathophysiology
8
Clinical Diagnosis of HIT
9
Clinical Diagnosis of HIT
10
Distribution of Platelet Count in HIT
11
Laboratory Testing for HIT
12
Prophylaxis and Treatment of HIT
Patient Risk Factors
13
Actions of Thrombin
14
Potential Advantages of Direct Thrombin Inhibitor
s
15
Direct Thrombin Inhibitors in HIT
16
Anticoagulants Not Indicated for HIT
17
Renal Plasma Flow Declines 50 by Age 80
18
Creatinine Clearance Is Reduced
in Elderly Patients
19
Direct Thrombin Inhibitors Pharmacologic and Clin
ical Parameters
20
Direct Thrombin Inhibitors Mechanism of Action
21
Direct Thrombin Inhibitors FDA Indications and U
sage
22
Pharmacokinetics of Argatroban
Infusion in Healthy Volunteers
23
Relationship at Steady-State Between Argatroban
Dose, Plasma Argatroban Concentration, and Antico
agulant Effect
24
Clinical Studies of Argatroban in HIT/HITTS
25
Efficacy Results for Argatroban
Primary Composite Endpoint
26
Slide 26
27
Major Hemorrhagic Events
28
Argatroban Dosing for Prophylaxis and Treatment
of HIT/HITTS
29
Clinical Studies of Argatroban Use
in PCI/HIT Patients
30
Argatroban Dosing PCI in Patients Who Have or
Are at Risk for HIT
31
Clinical Study Design Argatroban in PCI
32
Procedural Successof PCI With Argatroban
33
Major Bleeding With Argatroban in PCI
34
Important Safety Statement
35
Conversion to Oral Anticoagulant Therapy
36
Transitioning from Argatroban to Warfarin
37
Conversion toOral Anticoagulant Therapy
38
Argatroban in Prophylaxis and Treatment of
HIT/HITTS
39
Conclusions
40
CASE STUDIES
41
Case Study 1 Delayed-Onset HIT Presentation to
the Emergency Department
42
Case Study 1 (contd) Delayed-Onset HIT Presenta
tion to the Emergency Department
43
Case Study 1 (contd) Delayed-Onset HIT Treatmen
t
44
Case Study 1 (contd) Delayed-Onset HIT Key Poin
t
45
Case Study 2HIT in the CCU Background
46
Case Study 2 (contd) HIT in the CCU Presentatio
n
47
Case Study 2 (contd)HIT in the CCU Outcome
48
Case Study 2 (contd)HIT in the CCU Key Point
49
Case Study 3HIT in the CCU Background
50
Case Study 3 (contd)HIT in the CCU Assessment
51
Case Study 3 (contd)HIT in the CCU Assessment
52
Case Study 3 (contd)HIT in the CCU Key Points
53
Argatroban