阿加曲班
医学
加药
体质指数
回顾性队列研究
部分凝血活酶时间
肥胖
内科学
药效学
药代动力学
外科
麻醉
血小板
凝血酶
作者
Stephanie Elagizi,Kyle Davis
标识
DOI:10.1016/j.thromres.2018.01.011
摘要
Purpose Obesity is associated with significant alterations in pharmacokinetic and pharmacodynamic properties. The use of weight based anticoagulants such as argatroban may put obese patients at an increased risk of hemorrhagic events. The purpose of this study was to evaluate argatroban dosing requirements in obese vs non-obese patients. Methods This single-center, retrospective cohort study included patients ≥18 years with suspected HIT, treated with argatroban for ≥12 h. Patients were stratified by body mass index (BMI) into obese (BMI > 30 kg/m2) and non-obese (BMI ≤ 30 kg/m2) groups. The primary outcome was the median maintenance dose required to achieve two consecutive therapeutic activated partial thromboplastin times. Results A total of 121 patients were included. The median BMI in the obese vs non-obese groups was 35.8 vs 24.05 kg/m2 (p < .0001). Although statistically significant, there was no clinically significant difference in median maintenance argatroban dose in obese versus non-obese patients (1 vs 1 μg/kg/min; p = .01). In-hospital major bleeding and in-hospital thrombosis also did not differ between the two groups. Conclusion Obese patients require similar median argatroban maintenance doses when compared to non-obese patients. Based on these results argatroban should be dosed using actual body weight regardless of BMI.
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