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Dosing patterns and outcomes in African American, Asian, and Hispanic patients with heparin-induced thrombocytopenia treated with argatroban

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Abstract

We retrospectively evaluated dosing patterns and 37-day outcomes in argatroban-treated African American (n = 52), Asian (n = 13), and Hispanic (n = 14) patients with heparin-induced thrombocytopenia (HIT). The Asians required a lesser median dose (1.0 μg/kg/min) than the other groups (1.9 μg/kg/min, each) to achieve comparable activated partial thromboplastin times (medians: 61–69 s). Durations of therapy were similar (medians: 4.0–5.5 days). New thrombosis occurred in 11 (21%) African Americans, 1 (8%) Asian, and 1 (7%) Hispanic; of these 13 patients, 9 (69%) had baseline HIT-related thrombosis. Amputation occurred in 6 (12%) African Americans and 3 (21%) Hispanics; of these nine patients, 6 (67%) had diabetes. One (2%) African American and 1 (7%) Hispanic died from thrombosis. The composite of death due to thrombosis, amputation due to ischemic complications of HIT, or new thrombosis occurred in 14 (27%) African Americans, 1 (8%) Asian, and 4 (29%) Hispanics. Two (4%) African Americans and none others (0%) had major bleeding. These findings suggest that despite argatroban anticoagulation, African Americans and Hispanics may have worse outcomes in HIT than Asians. In minority patients with adverse HIT outcomes, baseline HIT-related thrombosis or diabetes is often present.

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Disclosure

MJH received consultancy fees from GlaxoSmithKline. IKJ has received grant support from GlaxoSmithKline. The authors have full control of all primary data and agree to allow the journal to review their data, if requested.

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Authors and Affiliations

  1. Clinical Science Consulting, Austin, TX, USA

    Marcie J. Hursting

  2. Cardiology Division, Massachusetts General Hospital and Harvard Medical School, Bigelow 800, 55 Fruit Street, Boston, MA, 02114, USA

    Ik-Kyung Jang

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  1. Marcie J. Hursting
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  2. Ik-Kyung Jang
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Correspondence to Ik-Kyung Jang.

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Hursting, M.J., Jang, IK. Dosing patterns and outcomes in African American, Asian, and Hispanic patients with heparin-induced thrombocytopenia treated with argatroban. J Thromb Thrombolysis 28, 10–15 (2009). https://doi.org/10.1007/s11239-008-0295-x

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  • DOI: https://doi.org/10.1007/s11239-008-0295-x

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