Combination therapy with lepirudin and a glycoprotein IIb/IIIa inhibitor may provide a safe and effective anticoagulation alternative for patients with heparin-induced thrombocytopenia requiring percutaneous coronary intervention.
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May support lepirudin plus GP IIb/IIIa inhibitor use in selected HIT patients for PCI; hypothesis-generating case report requiring prospective validation.
We evaluated a combination therapy using glycoprotein IIb/IIIa receptor antagonism and direct thrombin inhibition in nine patients with heparin-induced thrombocytopenia (HIT) undergoing 10 percutaneous coronary interventions (PCIs). In selected patients with HIT, the combination of a direct thrombin inhibitor, lepirudin, and abciximab, tirofiban, or eptifibatide appears to be a safe and effective anticoagulation strategy for PCI.
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Pinto et al. (2002) studied this question.
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