The Role of Direct Oral Anticoagulants in the Management of Heparin-Induced Thrombocytopenia

摘要

Heparin-induced thrombocytopenia (HIT) is a potentially life-threatening reaction to heparin that occurs in approximately 0.2% to 5% of patients and has an estimated mortality rate of 20%. The core management goal of HIT is to stop administration of heparin from all sources and initiate an alternative nonheparin anticoagulant. Current guidelines for the management of HIT recommend argatroban, danaparoid, bivalirudin, and fondaparinux to treat HIT. The current recommended agents require laboratory monitoring, parenteral administration, and a bridge to warfarin, rendering them labor-intensive and costly to healthcare systems. Direct oral anticoagulants have recently emerged as a potential option for the management of HIT.