Fondaparinux was associated with similar rates of thrombosis or thrombosis-related death compared to argatroban and danaparoid in patients with suspected HIT (16.5% vs 21.4%, P=0.424).
Cohort (n=239)
Does fondaparinux improve outcomes compared to argatroban or danaparoid in patients with suspected or confirmed heparin-induced thrombocytopenia?
Fondaparinux appears to have similar effectiveness and safety to argatroban and danaparoid for the treatment of suspected heparin-induced thrombocytopenia.
Absolute Event Rate: 16.5% vs 21.4%
p-value: p=0.424
Current guidelines for heparin-induced thrombocytopenia (HIT) management recommend heparin cessation and switching to a nonheparin anticoagulant (ie, argatroban, danaparoid) upon clinical suspicion. Fondaparinux may be effective but information supporting its use is limited. We retrospectively evaluated 239 patients who received a nonheparin anticoagulant (fondaparinux = 133, danaparoid = 59, and argatroban = 47) for suspected or confirmed HIT. A propensity score was constructed based on age, gender, creatinine, 4T scores, and comorbidity index, and used to match 133 patients to 60 controls. Outcomes were thrombosis or thrombosis-related death and major bleeding. In the matched population there were 22 (16.5%) episodes of thromboses in the fondaparinux group and 13 (21.4%) in the control group (χ(2) P = .424). Bleeding was observed in 28 (21.1%) patients in the fondaparinux group compared with 12 (20%) in the control group (χ(2) P = .867). Survival analysis, and subgroup and unmatched analyses showed similar results. In the fondaparinux group, 60% of patients received prophylactic doses. Fondaparinux has similar effectiveness and safety as argatroban and danaparoid in patients with suspected HIT. Prophylactic fondaparinux doses seem to be effective if no indication for full anticoagulation exists.
Kang et al. (Wed,) conducted a cohort in Suspected or confirmed heparin-induced thrombocytopenia (HIT) (n=239). Fondaparinux vs. Danaparoid and argatroban was evaluated on Thrombosis or thrombosis-related death (p=0.424). Fondaparinux was associated with similar rates of thrombosis or thrombosis-related death compared to argatroban and danaparoid in patients with suspected HIT (16.5% vs 21.4%, P=0.424).