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Antithrombotic therapy is required to manage heparin-induced thrombocytopenia (HIT), but currently approved agents such as argatroban must be given parenterally and closely monitored. Whether direct oral anticoagulants (DOACs) are sufficiently potent to control HIT-related thrombosis is uncertain.
To address this question, investigators at McMaster University in Canada examined their own experience and conducted a systematic review of the literature regarding the use of DOACs for initial treatment of acute HIT as well as after other primary therapies.
A total of 80 patients received a DOAC for treatment of probable HIT; 67% received rivaroxaban, 17% apixaban, and 16% dabigatran. Rivaroxaban was the primary therapy for 25 of 46 patients; only …