Argatroban is an effective direct thrombin inhibitor approved for chronic peripheral arterial obstructive disease and acute ischemic stroke, and serves as an alternative to heparin.
Argatroban is a versatile direct thrombin inhibitor with clinical applications in peripheral arterial disease, stroke, and coronary interventions, particularly useful as an alternative to heparin.
Argatroban, a direct thrombin inhibitor, is used clinically because of its safe and effective antithrombotic action. This drug of low molecular weight shows reversible inhibition of thrombin irrespective of whether thrombin is fibrin-bound or soluble. Optimal anticoagulant effects can easily be attained by monitoring with the activated partial thromboplastin time or whole-blood activated clotting time when a therapeutic range of argatroban equivalent to that of heparin is used. The antithrombotic action is simply detected with a chromogenic substrate assay. The clinical use of the drug in Japan was approved for the treatment of chronic peripheral arterial obstructive disease and acute ischemic stroke. For coronary artery disease in patients with deficiency of antithrombin activities attributable to either antithrombin III or heparin cofactor II deficiency, argatroban is effective as an anticoagulant. Acute coronary occlusion during and after percutaneous transluminal coronary angioplasty can be treated by argatroban as an alternative to heparin. The presence of platelets activated by a trace amount of thrombin is evidenced by modified methods of platelet aggregometry in acute ischemic stroke. Therefore, argatroban can render the platelets insensitive against the platelet hyperaggregation enhanced by thrombin.
Matsuo et al. (1997) conducted a review in Chronic peripheral arterial obstructive disease, acute ischemic stroke, and coronary artery disease. Argatroban vs. Heparin was evaluated. Argatroban is an effective direct thrombin inhibitor approved for chronic peripheral arterial obstructive disease and acute ischemic stroke, and serves as an alternative to heparin.