ABSTRACT
Concomitant anticoagulant therapy is essential in patients undergoing percutaneous
coronary interventions (PCI) to achieve prompt, early, complete, and sustained coronary
artery recanalization. Heparin has been historically used in these procedures. Argatroban
is a small-molecule, synthetic, reversible direct thrombin inhibitor. It has a predictable
anticoagulant response and also the potential to inhibit clot-bound thrombin. The
accessibility of argatroban to the active site of clot-bound thrombin is an advantage
for the treatment of coronary occlusion. This is accomplished by virtue of the low
molecular weight of argatroban (527 Da). Argatroban has been shown in clinical studies
to be a safe and effective anticoagulant during PCI. It has received approval from
the Food and Drug Administration for anticoagulation in patients with heparin-induced
thrombocytopenia who require PCI. Other clinical studies have shown that argatroban,
combined with the GP (glycoprotein) IIb/IIIa receptor inhibitors, can also be successfully
used for anticoagulation in coronary interventional procedures. Clinical trials in
the setting of PCI and related coronary interventional procedures are ongoing.
KEYWORDS
Antithrombin - argatroban - coronary intervention - recanalization - heparin-induced
thrombocytopenia (HIT)
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Omer IqbalM.D.
Department of Pathology, Hemostasis Research Laboratories, Building 102
Room 2646, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL 60153
Email: oiqbal@lumc.edu