What is the clinical evidence from this study?

Study design: Review. Population: Heparin-induced thrombocytopenia (HIT) or need for invasive cardiovascular intervention. Intervention: Parenteral direct thrombin inhibitors (argatroban and bivalirudin).

What question did this study set out to answer?

The study aims to review the laboratory monitoring methods for parenteral direct thrombin inhibitors in various clinical settings.

January 4, 2017Seminars in Thrombosis and Hemostasis

Laboratory Monitoring of Parenteral Direct Thrombin Inhibitors

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Key result

Parenteral direct thrombin inhibitors (argatroban and bivalirudin) are monitored using aPTT (target 1.5-3.0 times baseline for argatroban) and ACT depending on the clinical indication.

Design

Review

Authors

ARA. Joshua RobertsUniversity of California Davis Medical Center WDWilliam E. DagerUniversity of California, San Francisco ECElizabeth Van CottMassachusetts General Hospital

Discussion

Member takes

Implication

Offers heparin alternatives for HIT; review supports use but leaves comparative efficacy open.

Key Points

The study aims to review the laboratory monitoring methods for parenteral direct thrombin inhibitors in various clinical settings.
Overview of laboratory tests such as aPTT and ACT for monitoring DTIs.
Discussion of the pharmacokinetics of argatroban and bivalirudin.
Analysis of target aPTT ranges for HIT patients.
For HIT, target aPTT for argatroban is 1.5 to 3.0 and for bivalirudin is 1.5 to 2.5 times baseline.
DTI use during percutaneous coronary intervention can be evaluated using ACT.
DTI plasma concentrations can lead to elevations in international normalized ratio (INR).

Structured PICO

Intervention

Parenteral direct thrombin inhibitors (argatroban and bivalirudin)

This review outlines the pharmacological properties and appropriate laboratory monitoring strategies (such as aPTT and ACT) for parenteral direct thrombin inhibitors like argatroban and bivalirudin.

Cite This Study

Roberts et al. (2017) conducted a review in Heparin-induced thrombocytopenia (HIT) or need for invasive cardiovascular intervention. Parenteral direct thrombin inhibitors (argatroban and bivalirudin) was evaluated. Parenteral direct thrombin inhibitors (argatroban and bivalirudin) are monitored using aPTT (target 1.5-3.0 times baseline for argatroban) and ACT depending on the clinical indication.

synapsesocial.com/papers/6a5e7a6167fd328bf6efec95 https://doi.org/10.1055/s-0036-1597297

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Laboratory Monitoring of Parenteral Direct Thrombin Inhibitors

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Laboratory Monitoring of Parenteral Direct Thrombin Inhibitors

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider