AnticoagulantTherapy.ppt

Anticoagulant Therapy for Prophylaxis and Treatment of Thrombosis Associated With Heparin-Induced Thrombocytopenia Heparin-Induced Thrombocytopenia (HIT) Incidence of HIT Consequences of HIT Cumulative Frequency of Thrombosis Clinical Presentations of HIT Pathophysiology Clinical Diagnosis of HIT Clinical Diagnosis of HIT Distribution of Platelet Count in HIT Laboratory Testing for HIT Prophylaxis and Treatment of HIT: Patient Risk Factors Actions of Thrombin Potential Advantages of Direct Thrombin Inhibitors Direct Thrombin Inhibitors in HIT Anticoagulants Not Indicated for HIT Renal Plasma Flow Declines 50% by Age 80 Creatinine Clearance Is Reduced in Elderly Patients Direct Thrombin Inhibitors: Pharmacologic and Clinical Parameters Direct Thrombin Inhibitors: Mechanism of Action Direct Thrombin Inhibitors: FDA Indications and Usage Pharmacokinetics of Argatroban Infusion in Healthy Volunteers Relationship at Steady-State Between Argatroban Dose, Plasma Argatroban Concentration, and Anticoagulant Effect* Clinical Studies of Argatroban in HIT/HITTS Efficacy Results for Argatroban Primary Composite Endpoint Slide 26 Major Hemorrhagic Events* Argatroban Dosing for Prophylaxis and Treatment of HIT/HITTS Clinical Studies of Argatroban Use in PCI/HIT Patients Argatroban Dosing: PCI in Patients Who Have or Are at Risk for HIT Clinical Study Design: Argatroban in PCI Procedural Success of PCI With Argatroban Major Bleeding With Argatroban in PCI Important Safety Statement Conversion to Oral Anticoagulant Therapy Transitioning from Argatroban to Warfarin Conversion to Oral Anticoagulant Therapy Argatroban in Prophylaxis and Treatment of HIT/HITTS Conclusions CASE STUDIES Case Study #1 Delayed-Onset HIT: Presentation to the Emergency Department Case Study #1 (cont’d) Delayed-Onset HIT: Presentation to the Emergency Department Case Study #1 (cont’d) Delayed-Onset HIT: Treatment Case Study #1 (cont’d) Delayed-Onset HIT: Key Point Case Study #2 HIT in the CCU: Bac