In a patient with heparin-induced thrombocytopenia (HIT), when can I stop IV argatroban or bivalirudin, what do I switch to and for how long?

By William Aird

Once the platelet count is over 150 x 109/L, switch to warfarin (with appropriate overlap) or preferably to a DOAC (see 2018 American Society of Hematology [ASH] guideline recommendation 3.9 below). In case of HIT without thrombosis, continue for no longer than 3 months (typically 4-6 weeks). In the case of HIT complicated by thrombosis (termed HITT), treat for 3-6 months (see ASH guideline recommendation 3.8 below).

Subacute HIT A is the phase following platelet count recovery but before the functional assay becomes negative. See 2018 ASH guideline.