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Heparin-Induced Thrombocytopenia

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Anticoagulation Management

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Abstract

HIT is an immune-mediated reaction caused by antibodies to PF4/heparin complexes. HIT typically occurs 5–14 days after heparin exposure but could appear sooner in patients who were previously exposed to heparin within the past 100 days. Typical presentation includes a decline in platelet count by 50 % from baseline. The diagnosis of HIT can be complex and should utilize both clinical presentation and laboratory confirmation. The treatment of HIT consists of discontinuing the heparin-based agent and initiating a non-heparin anticoagulant. The most common treatment options are the direct thrombin inhibitors; however, there is emerging data to suggest the use of fondaparinux or the direct oral anticoagulants can also be used to treat HIT.

This chapter will focus on the pharmacist’s role in the diagnosis, laboratory interpretation, selection of treatment options, and overall management of HIT.

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Authors and Affiliations

  1. Pharmacy Services, Cardiology and Cardiothoracic Surgery, University of Wisconsin Hospital and Clinics, 600 Highland Ave, Madison, WI, 53792, USA

    Katie Willenborg PharmD, BCPS

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  1. Katie Willenborg PharmD, BCPS
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Correspondence to Katie Willenborg PharmD, BCPS .

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Editors and Affiliations

  1. Madison, Wisconsin, USA

    Anne Rose

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Willenborg, K. (2015). Heparin-Induced Thrombocytopenia. In: Rose, A. (eds) Anticoagulation Management. Adis, Cham. https://doi.org/10.1007/978-3-319-22602-6_9

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