Heparin induced thrombocytopenia – Cardiology MCQ

Alternative anticoagulation for a patient with HIT (Heparin induced thrombocytopenia) should not include:
a) Low molecular weight heparin
b) Warfarin
c) Argatroban
d) a and b
Correct answer: d) a and b
Both LMWH (low molecular weight heparin) and warfarin can worsen the thrombin generation and risk for thrombosis. LWMH can cross react with HIT antibodies in up to 90%.
Argatroban is a direct thrombin inhibitor which has been approved by U.S. Food and Drug Administration for treatment of thrombosis in HIT [1].
Reference:

1. Salter BS et al. Heparin-Induced Thrombocytopenia – A Comprehensive Clinical Review. J Am Coll Cardiol. 2016;67(21):2519-2532.