PMID- 19903167
OWN - NLM
STAT- MEDLINE
DCOM- 20100608
LR  - 20191111
VI  - 5
IP  - 1
DP  - 2010 Jan
TI  - Bivalirudin: alternative anticoagulation during cardiopulmonary bypass in 
      patients with heparin-induced thrombocytopenia.
PG  - 20-4
AB  - An estimated 1-3% of patients who receive therapeutic anticoagulation with 
      unfractionated heparin (UFH) develop antibodies to heparin with concomitant 
      development of thrombocytopenia, defined as HIT or Heparin-Induced 
      Thrombocytopenia. HIT complicates the management of patients presenting for 
      cardiac surgery, particularly those who need cardiopulmonary bypass (CPB) which 
      requires a large dose of UFH. A portion of these patients will have significant 
      thrombotic complications referred to as HITT (Heparin-induced thrombocytopenia 
      with thrombosis). In patients with established or suspected HIT, all heparin must 
      be withheld and an alternative form of anticoagulation utilized for CPB. Various 
      approaches and pharmacological alternatives have been described but no regimen 
      has replaced the routine use of UFH anticoagulation with protamine reversal after 
      CPB. We review the use of bivalirudin as a reliable and safe alternative 
      anticoagulation strategy during cardiopulmonary bypass with specific emphasis on 
      patients with HIT and outlining some recent patents.
FAU - Grubb, Kendra J
AU  - Grubb KJ
AD  - Division of Cardiothoracic Surgery, Department of Surgery, L. Weiss Memorial 
      Hospital, University of Illinois, College of Medicine, Chicago, Illinois, USA.
FAU - Salehi, Payam
AU  - Salehi P
FAU - Chedrawy, Edgar G
AU  - Chedrawy EG
LA  - eng
PT  - Journal Article
PT  - Review
PL  - United Arab Emirates
TA  - Recent Pat Cardiovasc Drug Discov
JT  - Recent patents on cardiovascular drug discovery
JID - 101263805
RN  - 0 (Anticoagulants)
RN  - 0 (Hirudins)
RN  - 0 (Peptide Fragments)
RN  - 0 (Recombinant Proteins)
RN  - 9005-49-6 (Heparin)
RN  - TN9BEX005G (bivalirudin)
SB  - IM
MH  - Anticoagulants/adverse effects/pharmacology/*therapeutic use
MH  - Cardiopulmonary Bypass/*methods
MH  - Heparin/adverse effects
MH  - Hirudins/adverse effects/pharmacology
MH  - Humans
MH  - Patents as Topic
MH  - Peptide Fragments/adverse effects/pharmacology/*therapeutic use
MH  - Recombinant Proteins/adverse effects/pharmacology/therapeutic use
MH  - Thrombocytopenia/chemically induced
RF  - 37
EDAT- 2009/11/12 06:00
MHDA- 2010/06/09 06:00
CRDT- 2009/11/12 06:00
PHST- 2009/07/24 00:00 [received]
PHST- 2009/09/09 00:00 [accepted]
PHST- 2009/11/12 06:00 [entrez]
PHST- 2009/11/12 06:00 [pubmed]
PHST- 2010/06/09 06:00 [medline]
AID - PRC-240709 [pii]
AID - 10.2174/157489010790192674 [doi]
PST - ppublish
SO  - Recent Pat Cardiovasc Drug Discov. 2010 Jan;5(1):20-4. doi: 
      10.2174/157489010790192674.