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Heparin-induced thrombocytopenia (HIT) occurs in as many as 3% of patients who are exposed to this drug, and some 20% of patients with HIT suffer venous or arterial thrombosis when heparin is withdrawn. The antibodies that are formed in response to heparin cross-react with low-molecular-weight heparins, and administration of warfarin during the acute stage of HIT can result in limb gangrene. Direct thrombin inhibitors (DTIs) are effective in preventing and treating thrombosis and are approved by the U.S. FDA for this purpose.
Researchers in France and Switzerland retrospectively evaluated predictive factors for thrombosis and major bleeding in 181 patients with HIT who were treated with the DTI, lepirudin (Refludan). During hospitalization, …