Heparin-induced thrombocytopenia, part 2: Clinical course and treatment. How can drug selection help spare life and limb?

Increasing evidence indicates that management of "isolated" heparin-induced thrombocytopenia (HIT) should include substitution of heparin by an alternative anticoagulant, such as danaparoid, lepirudin, or argatroban. Usually, one of these agents is given in therapeutic doses until platelet count recovery has occurred. Because of delays in obtaining HIT antibody test results, the initial decision to stop heparin and give an alternative agent …