Alternative Anticoagulation During Percutaneous Coronary Intervention

1
Alternative Anticoagulation During Percutaneous
Coronary Intervention
in HIT Patients
2
Heparin-Induced Thrombocytopenia (HIT)
3
Incidence of HIT
4
Relationship of HIT and Thrombosis
5
Cumulative Risk of Thrombosis in Patients With
Diagnosed HIT
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
Alternative Anticoagulants
14
Renal Plasma Flow Declines 50 by Age 80
15
Creatinine Clearance Is Reduced
in Elderly Patients
16
Direct Thrombin Inhibitors Pharmacologic and Clin
ical Parameters
17
Direct Thrombin Inhibitors Mechanism of Action
18
Direct Thrombin Inhibitors FDA Indications and U
sage
19
Pharmacokinetics of Argatroban
Infusion in Healthy Volunteers
20
Relationship at Steady State Between Argatroban
Dose, Plasma Argatroban Concentration, and aPTT
21
Clinical Studies of Argatroban in HIT/HITTS
22
Efficacy Results for Argatroban Components of
Composite Endpoint
23
Bleeding Incidence With Argatroban
24
Argatroban Dosing for Prophylaxis and Treatment o
f HIT/HITTS
25
HIT and PCI
26
PCI Is Inherently Thrombogenic
27
Actions of Thrombin
28
The PCI Patient and HIT
29
Problems With Heparin Therapy
30
Potential Advantages of Direct Thrombin
Inhibitors Over Heparin
31
Hirulog Angioplasty Study
32
Clinical Studies of Argatroban Use
in PCI/HIT Patients
33
Clinical Study Design Argatroban in PCI
34
Clinical Study Design Argatroban in PCI
35
Number of Procedures During PCI With Argatroban
36
ACT During PCI With Argatroban
37
Physician Satisfaction With Argatroban for PCI
38
Procedural Successof PCI With Argatroban
39
Major Bleeding With Argatroban in PCI
40
Important Safety Statement
41
Argatroban Dosing PCI in Patients
Who Have or Are at Risk for HIT
42
PCI Dosing in Renal or Hepatic Impairment
43
Conversion to Oral Anticoagulant Therapy
44
Conversion to Warfarin
45
Argatroban in HIT/HITTS
46
Argatroban in PCI Patients With or at Risk for HI
T
47
Conclusions
48
Argatroban