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Published on: March 15, 2022

Effect of body mass index on Argatroban therapy during percutaneous coronary intervention

Marcie J Hursting1, Ik-Kyung Jang

  • 1Clinical Science Consulting, Austin, TX, USA.

Journal of Thrombosis and Thrombolysis
|May 29, 2007
PubMed

Insights

Obesity does not necessitate argatroban dose adjustments during percutaneous coronary intervention (PCI). Actual body weight-based dosing and activated clotting time (ACT) targeting are effective for obese and non-obese patients undergoing PCI.

Area of Science:

  • Cardiology
  • Pharmacology
  • Medical Research

Background:

  • Obesity is prevalent in patients undergoing percutaneous coronary intervention (PCI).
  • Argatroban, a direct thrombin inhibitor, is crucial for patients with or at risk of heparin-induced thrombocytopenia (HIT) during PCI.
  • Its use in non-HIT patients with glycoprotein IIb/IIIa inhibition has also been explored.

Purpose of the Study:

  • To investigate the impact of body mass index (BMI), particularly obesity (BMI > 30 kg/m2), on argatroban therapy efficacy and safety during PCI.
  • To determine if argatroban dosing requires adjustment in obese patients undergoing PCI.

Main Methods:

  • Retrospective analysis of data from previous argatroban studies in PCI patients (HIT and non-HIT groups).
  • Evaluation of BMI's association with activated clotting time (ACT) response, infusion dose, and ACT decline post-PCI.
  • Comparison of additional bolus frequency and clinical outcomes between obese and non-obese patients.

Main Results:

  • No significant association was found between BMI and ACT response, mean infusion dose, or time to ACT normalization.
  • Obese and non-obese patients required additional argatroban boluses at similar rates.
  • Clinical outcomes, including ischemic complications and major bleeding, did not differ significantly between obese and non-obese groups.

Conclusions:

  • Argatroban therapy, adjusted for actual body weight and targeted to ACT levels, is effective in obese patients undergoing PCI.
  • Dose adjustments for obesity (BMI up to 50.9 kg/m2) are not necessary.
  • Current weight-based dosing strategies are appropriate for managing argatroban in PCI patients across a wide BMI range.
Abstract

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