ABSTRACT
The treatment for heparin-induced thrombocytopenia (HIT) has undergone important changes over the past decade. Until recently, clinicians had very few options for treating this potentially devastating syndrome. Fortunately, with the development of several contemporary anticoagulants, physicians now have a number of novel treatment options. These include danaparoid, an indirect (antithrombindependent) factor Xa inhibitor (see Chapter 13) and the direct thrombin inhibitors (DTIs), including recombinant hirudin (r-hirudin) (e.g., lepirudin) (see Chapter 14) and the small molecule DTI, argatroban (Alving, 2003; Chong, 2003; Warkentin, 2003) (see Chapter 15). The synthetic pentasaccharide (fondaparinux), another indirect factor Xa inhibitor, has also been used “off-label” to treat HIT (Spinler, 2006).
