| Abstract [eng] |
Aim of the study. To select and assess studies about acute myocardial infarct and heparin induced thrombocytopenia. Objectives: to understand the mechanisms of heparin induced thrombocytopenia, to assess the methos of diagnosing the disease and to review treatment options. Methods. A literature review was performed by using Pubmed and Google Scholar search systems, choosing articles published from 2002 to 2022. Results. Symptoms of heparin-induced thrombocytopenia have been reported to occur 5 to 14 days after initiation of heparin therapy in 0.5-5% of patients (the risk increases in myocardial infarction). This condition results in the formation of antibodies directed against the complex of heparin and platelet factor 4, which can lead to the development of thrombosis. During myocardial infarction, due to the prothrombic condition of the body, existing vascular damage may spread or occur in new areas. The main diagnostic methods of the disease are clinical calculation of 4T score, immunoenzymatic testing of antibodies and their function. Treatment begins with discontinuation of any form of heparin and administration of an alternative anticoagulant. Choices include direct thrombin inhibitors (argatroban, bivalirudin) and factor Xa inhibitors (danaparoid, fondaparinux), but direct oral anticoagulants are also increasingly described in the literature. Conclusions. Heparin-induced thrombocytopenia is a life-threatening phenomenon of an immune response. Due to a higher risk of developing the disease, patients with myocardial infarction should be given special attention to ensure timely diagnosis and appropriate treatment to avoid complications. Basic clinical and laboratory diagnostic methods allow reliable diagnosis of the disease, but waiting for results should not be a reason to delay treatment - it should be initiated as soon as the condition is suspected. The choice of medication depends on a variety of factors and should be considered on an individual patient basis, as there is a lack of reliable studies to select the safest and most effective anticoagulant. |
