What is the bivalirudin dosing for PCI?

Bivalirudin: 0.75 mg/kg IV bolus then 1.75 mg/kg/h during PCI; reduce to 0.25 mg/kg/h post-PCI if needed; renal adjustment: CrCl 10-29: maintain bolus, reduce infusion to 1.0 mg/kg/h; dialysis: 0.25 mg/kg/h infusion.

What argatroban dose treats HIT?

Argatroban: 0.5-2 mcg/kg/min continuous infusion; target aPTT 1.5-3x baseline (45-90s); reduce to 0.5 mcg/kg/min in hepatic impairment or post-cardiac surgery; no renal dose adjustment needed (hepatically metabolised).

What is the 4Ts score for HIT diagnosis?

4Ts: Thrombocytopenia (>50% fall or nadir 20-100 = 2pts); Timing (days 5-10 or ≤1 day if prior HIT = 2pts); Thrombosis (new or progression = 2pts); oTher cause (none plausible = 2pts); ≤6 = intermediate/high probability - use DTI.

How should transition from argatroban to warfarin be managed?

Warfarin initiated when platelets >150; argatroban raises INR 1.5-2x independently (artifactual elevation); stop argatroban when INR >4.0 while on argatroban + warfarin, then check INR 4-6h later; continue warfarin if INR >2.0; argatroban affects chromogenic anti-Xa assay.

What HIT antibody test confirms the diagnosis?

Anti-PF4/heparin ELISA: sensitive (~95%) but not specific; positive OD >0.4; confirm with serotonin release assay (SRA) - the gold standard for HIT diagnosis; SRA >20% serotonin release at 0.1 U/mL heparin = positive; ELISA alone guides urgent DTI initiation.

Bivalirudin and Argatroban Direct Thrombin Inhibitor Dosing

Calculates bivalirudin dosing for PCI/ACS and argatroban dosing for HIT (heparin-induced thrombocytopenia), with renal/hepatic dose adjustment and aPTT target monitoring (1.5-3x baseline).

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Frequently Asked Questions

What is the bivalirudin dosing for PCI?

What argatroban dose treats HIT?

What is the 4Ts score for HIT diagnosis?

How should transition from argatroban to warfarin be managed?

What HIT antibody test confirms the diagnosis?