Update on the Treatment of Heparin-Induced Thrombocytopenia

Heparin, a natural glycosaminoglycan, was first discovered in 1916 by Mclean and initially was used as an anticoagulant in 1935.¹  Today, the use of unfractionated heparin and low-molecular-weight heparin remains widespread for the treatment and prevention of various thromboembolic disorders. Benefits of unfractionated heparin include its quick onset of action, short half-life, ease of monitoring, and reversibility.²  Low-molecular-weight heparin has the additional advantages of more predictable anticoagulant activity, less frequent monitoring, and potential use in the ambulatory setting.¹  Heparin-induced thrombocytopenia (HIT) is a potentially life-threatening complication of heparin exposure associated with potential thrombosis, limb gangrene and amputation, and death.^3,4  The incidence of HIT ranges from less than 0.1% to 5% of patients and varies according to patient factors.³  The risk is highest in patients receiving unfractionated heparin (as opposed to low-molecular-weight heparin), those undergoing cardiac surgery, and those receiving therapeutic doses.^4–...