argatroban / Generic mfg. - LARVOL DELTA

IVC syndrome in a patient with Factor V Leiden mutation. (PubMed, BMJ Case Rep) - "She was subtherapeutic on heparin and was started on argatroban. On discharge, she was transitioned to fondaparinux."

Journal • Cardiovascular • Critical care • Hematological Disorders • Pain • Thrombosis

Autoimmune heparin-induced thrombocytopenia following cardiac surgery. (PubMed, BMJ Case Rep) - "Anticoagulation was changed to argatroban plus high-dose intravenous immunoglobulin. Persisting hypercoagulability prompted a switch to fondaparinux, with gradual platelet count recovery (155×109/L, POD62); neurological abnormalities resolved. Laboratory evaluation confirmed HIT antibodies with heparin-independent platelet-activating properties, indicating autoimmune HIT (aHIT). Besides profound thrombocytopenia (platelet count nadir, 13×10⁹/L), novel aspects of this case of aHIT include early postoperative onset (before POD5) resulting from preoperative heparin exposure and a unique laboratory aHIT antibody profile with partial resistance to Fc receptor blockade."

Journal • Cardiovascular • Hematological Disorders • Immunology • Thrombocytopenia

Delayed-onset, persisting autoimmune heparin-induced thrombocytopenia with thrombosis following craniofacial surgery. (PubMed, BMJ Case Rep) - "Despite cessation of UFH and initiation of argatroban, thrombocytopenia did not improve...The patient was treated with immunoglobulin, resulting in a rapid recovery of platelet counts. This case highlights the importance of early recognition and appropriate management of aHIT, especially in patients with persisting thrombocytopenia despite standard HIT therapy."

Journal • Cardiovascular • Hematological Disorders • Immunology • Musculoskeletal Diseases • Orthopedics • Pulmonary Embolism • Respiratory Diseases • Thrombocytopenia • Thrombosis • Venous Thromboembolism

Alternative anticoagulants in heparin-sensitive patients undergoing carotid artery interventions: A scoping review. (PubMed, J Vasc Surg) - "In patients with suspected UFH hypersensitivity requiring carotid intervention, bivalirudin appears to be a safe alternative, while argatroban and LMWH may represent acceptable options based on limited available evidence. Bivalirudin, in particular, is associated with reduced perioperative bleeding and no increase in periprocedural complications."

Journal • Review • Cardiovascular • Hematological Disorders • Immunology • Thrombocytopenia

Circadian Rhythm and Efficacy of Argatroban in Ischemic Stroke with Alteplase: A Post Hoc Analysis of the ARAIS Trial. (PubMed, CNS Drugs) - P4 | "This is the first report that suggested a potential association between argatroban and a higher rate of excellent functional outcome in patients with acute ischemic stroke who received intravenous alteplase during the nighttime. This finding requires further validation in future studies."

Journal • Retrospective data • Cardiovascular • Cerebral Hemorrhage • Hematological Disorders • Ischemic stroke

Thromboembolism related to heparin-induced thrombocytopenia during Impella support after cardiac surgery for free wall rupture: a case report. (PubMed, AME Case Rep) - "Anticoagulation therapy was subsequently switched from heparin to argatroban. This case illustrates the difficulty in diagnosing HIT in patients on Impella support in the acute postoperative period after cardiac surgery. Clinicians should be vigilant for Impella-associated thromboembolism and understand its possible mechanisms to ensure appropriate diagnosis and prevention."

Journal • Cardiovascular • Heart Failure • Hematological Disorders • Myocardial Infarction • Pain • Thrombocytopenia

Stroke Phenotypes and Treatment Response: A Latent Class Analysis of an Acute Stroke Trial (ISC 2026) - "INTRODUCTION: The Multi-Arm Optimization of Stroke Thrombolysis (MOST) trial found no benefit of adjunctive argatroban or eptifibatide with intravenous thrombolytic therapy for acute ischemic stroke and reported significantly greater post-stroke disability and higher mortality in the argatroban group. Adjustment for stroke phenotypes attenuated the relationship between argatroban and functional outcomes, eliminating statistical significance. However, stroke profiles did not account for the excess mortality observed in the argatroban arm. These findings suggest that stratified stroke phenotypes may help explain observed differences in functional recovery but are insufficient to explain mortality risk."

Cardiovascular • Ischemic stroke

Observations from Hotline Usage in an Acute Stroke Trial: Characteristics of Complex Cases (ISC 2026) - "Background The Multi-arm Optimization of Stroke Thrombolysis (MOST) trial was a single-blind, phase 3, randomized trial evaluating whether adjunctive treatment with argatroban or eptifibatide alongside IV thrombolysis improved outcomes. Higher sICH and mortality in the hotline group likely reflect the greater complexity of cases for which support was sought. These findings highlight the value of 24/7 expert support in acute care trials to guide decision-making and uphold protocol integrity under pressure."

Clinical • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders

Role of argatroban infusion in controlling clot formation in post-cardiac surgical extracorporeal membrane oxygenation in pediatrics: A case series of three patients. (PubMed, Perfusion) - "While patients were successfully decannulated, complications included arterial thrombosis, circuit thrombosis, and mild intracranial hemorrhage. In our series, effective argatroban doses ranged widely (0.18 to 2.13 mcg/kg/min), highlighting the need for individualized dosing, while optimal monitoring strategies remain to be established; lower doses are recommended for patients with hepatic impairment."

Journal • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Hepatology • Pediatrics • Thrombocytopenia • Thrombosis

Vaccine-Induced Immune Thrombotic Thrombocytopenia (VITT)-like Syndrome: A Case Report and Some Considerations on a Novel Diagnostic and Therapeutic Challenge. (PubMed, Diagnostics (Basel)) - "Thrombolysis with alteplase was also ineffective...Therefore, argatroban was initiated instead of UFH therapy and intravenous immune globulin (IVIG) was administered...The clinical suspicion of an anti-PF4 immune disorder should be considered in cases of severe, otherwise unexplained, thrombotic events associated with thrombocytopenia. Specific tests like HIPA and PIPA are essential for definitive diagnosis."

Journal • Cardiovascular • Genetic Disorders • Hematological Disorders • Immunology • Pulmonary Embolism • Respiratory Diseases • Septic Shock • Thrombocytopenia • Venous Thromboembolism

Argatroban Anticoagulation for Heparin Induced Thrombocytopenia After Heartmate 3 Implantation: A Case Series. (PubMed, Transplant Proc) - "Argatroban appears to be an effective and safe alternative anticoagulant for HIT after LVAD implantation, enabling platelet recovery without a significant increase in bleeding or thrombotic events. Differentiating complications attributable to HIT or argatroban from those inherent to LVAD support remains challenging, given the device's intrinsic risks of thrombosis, bleeding, and mortality."

Journal • Cardiovascular • Hematological Disorders • Immunology • Infectious Disease • Inflammatory Arthritis • Metabolic Disorders • Pneumonia • Respiratory Diseases • Septic Shock • Thrombocytopenia • Thrombosis

Severe Arterial Thrombosis Revealing Underlying Nephrotic Syndrome. (PubMed, Cureus) - "Due to heparin resistance from severe hypoalbuminaemia, anticoagulation was switched from unfractionated heparin to argatroban. Immunosuppression with high-dose steroids and rituximab was initiated, chosen to cover potential causes including minimal change disease (MCD), membranous nephropathy (MN), and focal segmental glomerulosclerosis (FSGS)...This case highlights the need for early urine protein testing in unexplained hypoalbuminaemia or arterial thrombosis, to investigate nephrotic syndrome as a potential cause. Prompt treatment is key to preserve kidney function and reduce the chance of limb loss."

Journal • Cardiovascular • Focal Segmental Glomerulosclerosis • Glomerulonephritis • Hematological Disorders • Hypertension • Infectious Disease • Musculoskeletal Pain • Nephrology • Pain • Renal Disease • Thrombosis

Heparin-Induced Thrombocytopenia in a Patient With Postoperative Pulmonary Embolism: D-dimer Re-elevation and Progressive Pulmonary Artery Thrombosis. (PubMed, Cureus) - "Argatroban was later replaced with edoxaban after platelet recovery. Clinicians should maintain a high index of suspicion for HIT in heparin-treated patients presenting with thrombocytopenia, with supportive laboratory findings such as unexpected D-dimer elevation, even in the absence of new or worsening symptoms. Early recognition and prompt management are essential to improve outcomes and prevent severe complications or death."

Journal • Cardiovascular • Hematological Disorders • Pulmonary Embolism • Respiratory Diseases • Thrombocytopenia • Venous Thromboembolism

Nitric oxide in the ECMO circuit as a treatment option for heparin-induced thrombocytopenia: A case report. (PubMed, Perfusion) - "This intricate, self-reinforcing process results in a prothrombotic state, predisposing patients to arterial, venous, or oxygenator thrombosis. Unfractionated heparin is the standard anticoagulant chosen in ECMO patients to prevent such complications.Case ReportIn this case report our patient presented heparin-induced thrombocytopenia (HIT), a possible complication.DiscussionAlternative strategies such as bivalirudin and argatroban are possible options but due the unavailability of those medications at our institution, nitric oxide (NO) via sweep-gas flow was deemed a reasonable alternative considering it's anti-aggregant effect.ConclusionThis case report details the use of NO as a possible alternative anticoagulant strategy in a patient with ECMO complicated by HIT."

Journal • Cardiovascular • Hematological Disorders • Thrombocytopenia • Thrombosis • Transplantation

β-CD-polyethyleneimine hybrid alginate macrospheres for the efficient removal of indoxyl sulfate. (PubMed, Biomed Mater) - "The surface polydopamine (PDA) and argatroban (AG) modification resulted in enhanced biocompatibility and anticoagulation...Moreover, the lower hemolysis rate (0.36 %) and longer anticoagulation-related factors (APTT: 161.5 s; TT, 35.6 s) also revealed favorable biocompatibility and anticoagulation. This study presents a new way to designate blood purification materials and highlights their potential in clinical hemoperfusion treatment."

Journal • Chronic Kidney Disease • Hematological Disorders • Nephrology

Efficacy of combined atorvastatin and argatroban therapy in acute cerebral infarction. (PubMed, Pak J Pharm Sci) - "Atorvastatin combined with argatroban can effectively improve the cerebral hemodynamics, coagulation and endothelial function and reduce the inflammation in ACI patients, thus exerting a good therapeutic efficacy."

Journal • CNS Disorders • Inflammation • Oncology • CRP • EDN1 • IL6 • TNFA

Extensive Lower Extremity Venous Thrombosis and Phlegmasia From Heparin-Induced Thrombocytopenia Following Percutaneous Coronary Intervention (PCI) Successfully Managed With Limb-Salvage Surgery. (PubMed, Cureus) - "Given recent heparin exposure and new thrombocytopenia, her 4Ts score indicated intermediate probability for heparin-induced thrombocytopenia (HIT), prompting immediate discontinuation of heparin and initiation of argatroban...She remained hemodynamically stable, achieved platelet recovery on non-heparin anticoagulation, and survived a condition historically associated with high mortality. This case highlights the potential for HIT to present with limb-threatening thrombosis after hospital discharge and the importance of early recognition, appropriate anticoagulation, and timely surgical intervention in optimizing limb and patient outcomes."

Journal • Cardiovascular • Hematological Disorders • Thrombocytopenia • Thrombosis

Heparin-Induced Thrombocytopenia Causing Early Venous Thrombosis and Free Flap Failure After Mandibular Reconstruction: A Case Report. (PubMed, Cureus) - "This case underscores that in microsurgical patients, repeated venous thrombosis with preserved inflow should prompt the immediate consideration of HIT: stop all heparin (including flushes), begin a non-heparin anticoagulant while arranging confirmatory testing, and involve hematology early. We outline a practical timeline, platelet fall, 4Ts scoring, and differential diagnosis for postoperative thrombocytopenia to aid in the rapid recognition and management of similar cases."

Journal • Cardiovascular • Critical care • Hematological Disorders • Thrombocytopenia • Thrombosis

Heparin Resistance in Cardiac Surgery with Cardiopulmonary Bypass: Mechanisms, Clinical Implications, and Evidence-Based Management. (PubMed, Medicina (Kaunas)) - "Pre-bypass risk assessment, multimodal monitoring, and an algorithm prioritizing UFH optimization, AT repletion, and timely use of direct thrombin inhibitors provide a pragmatic framework to limit thrombosis and bleeding. Harmonized definitions and comparative trials remain priorities."

Journal • Review • Cardiovascular • Genetic Disorders • Hematological Disorders • Infectious Disease • Inflammation • Obesity • Septic Shock • Thrombocytosis • Thrombosis

Balancing Bleeding and Clot: Type 2 Heparin-Induced Thrombocytopenia With Extensive Thromboses in a Patient With Subdural Hematoma. (PubMed, Cureus) - "An 87-year-old man with essential thrombocythemia and atrial fibrillation on rivaroxaban presented with a right subacute subdural hematoma after a fall...He was started on argatroban and later transitioned to apixaban 5 mg twice daily once hematoma stability was confirmed...Tailored multidisciplinary management can achieve favorable outcomes. This case highlights the need for further research into risk stratification frameworks that integrate concurrent hematologic disorders and competing thrombotic-hemorrhagic conditions to guide safe anticoagulant selection and timing in type 2 HIT, especially with a concurrent bleed."

Journal • Atrial Fibrillation • Cardiovascular • Cerebral Hemorrhage • CNS Disorders • Essential Thrombocythemia • Hematological Disorders • Myeloproliferative Neoplasm • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Thrombocytopenia • Thrombocytosis • Thrombosis

Evaluation of Argatroban in Sepsis-Induced Coagulopathy: A Retrospective Study Based on MIMIC-IV Database. (PubMed, Clin Appl Thromb Hemost) - "Finally, Kaplan-Meier curve was used to compare the survival rate between the two groups.OutcomeAfter PSM, 108 patients who received Argatroban were matched with 108 patients who did not receive Argatroban. In terms of outcomes, Argatroban admission to ICU was associated with a higher risk of death 30 days after ICU admission for SIC patients (HR = 1.800; 95%CI: 1.064∼3.043; P = .043) correlation.ConclusionArgatroban is not recommended for anticoagulant therapy in SIC patients."

Journal • Retrospective data • Cardiovascular • Critical care • Hematological Disorders • Infectious Disease • Septic Shock • Thrombosis

HIMA: HEPARINS: INTERFERENCE IN ARGATROBAN MEASUREMENT (clinicaltrials.gov) - P=N/A | N=70 | Recruiting | Sponsor: University Hospital, Strasbourg, France

New trial • Cardiovascular

Evaluation of a Standardized Electronic Argatroban Dosing Nomogram for Heparin-Induced Thrombocytopenia: A Retrospective Study. (PubMed, Am J Nurs) - "The implementation of a standardized electronic argatroban dosing nomogram and e-CDS tools did not impact time to reach therapeutic aPTT values but was associated with improved nurse nomogram compliance and a reduction in bleeding events."

Journal • Retrospective data • Cardiovascular • Hematological Disorders • Thrombocytopenia • Thrombosis

Beyond activated partial thromboplastin time: viscoelastic monitoring of argatroban in the critically ill. (PubMed, Br J Anaesth) - "Schiferer and colleagues report that the ecarin clotting time measured with ClotPro® correlates strongly with plasma argatroban concentrations, whereas activated partial thromboplastin time (aPTT) shows little or no association, particularly above 55 s. Their important findings question the reliability of aPTT for argatroban titration in critically ill patients. Although the study supports implementation of viscoelastic argatroban monitoring, it also highlights the pressing need for outcome-driven validation of standardised therapeutic thresholds."

Journal • Hematological Disorders • Thrombocytopenia

Systemic Argatroban vs Heparin in Patients with Microaxial Flow Pumps (ASHP 2025) - No abstract available

Clinical