PMC:7388103 / 7806-9076 JSONTXT

{"project":"LitCovid_Glycan-Motif-Structure","denotations":[{"id":"T33","span":{"begin":81,"end":88},"obj":"https://glytoucan.org/Structures/Glycans/G00021MO"},{"id":"T34","span":{"begin":81,"end":88},"obj":"https://glytoucan.org/Structures/Glycans/G54161DR"},{"id":"T35","span":{"begin":100,"end":107},"obj":"https://glytoucan.org/Structures/Glycans/G00021MO"},{"id":"T36","span":{"begin":100,"end":107},"obj":"https://glytoucan.org/Structures/Glycans/G54161DR"},{"id":"T37","span":{"begin":140,"end":147},"obj":"https://glytoucan.org/Structures/Glycans/G00021MO"},{"id":"T38","span":{"begin":140,"end":147},"obj":"https://glytoucan.org/Structures/Glycans/G54161DR"}],"text":"The first step in the management of highly suspected or confirmed HIT is to stop heparin (including heparin flushes), and to initiate a non-heparin anticoagulant, to prevent thrombotic events, in the setting of ongoing massive thrombin generation.4 Available options for anticoagulation include argatroban, bivalirudin, danaparoid, fondaparinux, or a direct oral anticoagulant.6 Argatroban is a reversible inhibitor of thrombin5 with a short half-life and is not renally cleared. It is commonly used in the United States for HIT.4 In 2 multicenter trials of patients with HIT, argatroban resulted in reduced composite endpoint of death, amputation, and thrombosis, when compared with historic controls.5 A major concern with argatroban is potential under-anticoagulation in patients with elevated partial thromboplastin time, secondary to additional coagulopathies (hepatic dysfunction, prior anticoagulation with warfarin, consumptive coagulopathy, and more recently, COVID-19).4 Partial thromboplastin time confounding may also occur in the presence of a nonspecific inhibitor (such as lupus anticoagulant).8 This would increase the risk of thrombosis and limb loss. Data supporting the efficacy of argatroban is limited to patients with suspected or confirmed HIT.8,9"}

{"project":"LitCovid-PD-FMA-UBERON","denotations":[{"id":"T58","span":{"begin":81,"end":88},"obj":"Body_part"},{"id":"T59","span":{"begin":100,"end":107},"obj":"Body_part"},{"id":"T60","span":{"begin":140,"end":147},"obj":"Body_part"},{"id":"T61","span":{"begin":1158,"end":1162},"obj":"Body_part"}],"attributes":[{"id":"A58","pred":"fma_id","subj":"T58","obj":"http://purl.org/sig/ont/fma/fma82839"},{"id":"A59","pred":"fma_id","subj":"T59","obj":"http://purl.org/sig/ont/fma/fma82839"},{"id":"A60","pred":"fma_id","subj":"T60","obj":"http://purl.org/sig/ont/fma/fma82839"},{"id":"A61","pred":"fma_id","subj":"T61","obj":"http://purl.org/sig/ont/fma/fma7182"}],"text":"The first step in the management of highly suspected or confirmed HIT is to stop heparin (including heparin flushes), and to initiate a non-heparin anticoagulant, to prevent thrombotic events, in the setting of ongoing massive thrombin generation.4 Available options for anticoagulation include argatroban, bivalirudin, danaparoid, fondaparinux, or a direct oral anticoagulant.6 Argatroban is a reversible inhibitor of thrombin5 with a short half-life and is not renally cleared. It is commonly used in the United States for HIT.4 In 2 multicenter trials of patients with HIT, argatroban resulted in reduced composite endpoint of death, amputation, and thrombosis, when compared with historic controls.5 A major concern with argatroban is potential under-anticoagulation in patients with elevated partial thromboplastin time, secondary to additional coagulopathies (hepatic dysfunction, prior anticoagulation with warfarin, consumptive coagulopathy, and more recently, COVID-19).4 Partial thromboplastin time confounding may also occur in the presence of a nonspecific inhibitor (such as lupus anticoagulant).8 This would increase the risk of thrombosis and limb loss. Data supporting the efficacy of argatroban is limited to patients with suspected or confirmed HIT.8,9"}

{"project":"LitCovid-PD-UBERON","denotations":[{"id":"T12","span":{"begin":1158,"end":1162},"obj":"Body_part"}],"attributes":[{"id":"A12","pred":"uberon_id","subj":"T12","obj":"http://purl.obolibrary.org/obo/UBERON_0002101"}],"text":"The first step in the management of highly suspected or confirmed HIT is to stop heparin (including heparin flushes), and to initiate a non-heparin anticoagulant, to prevent thrombotic events, in the setting of ongoing massive thrombin generation.4 Available options for anticoagulation include argatroban, bivalirudin, danaparoid, fondaparinux, or a direct oral anticoagulant.6 Argatroban is a reversible inhibitor of thrombin5 with a short half-life and is not renally cleared. It is commonly used in the United States for HIT.4 In 2 multicenter trials of patients with HIT, argatroban resulted in reduced composite endpoint of death, amputation, and thrombosis, when compared with historic controls.5 A major concern with argatroban is potential under-anticoagulation in patients with elevated partial thromboplastin time, secondary to additional coagulopathies (hepatic dysfunction, prior anticoagulation with warfarin, consumptive coagulopathy, and more recently, COVID-19).4 Partial thromboplastin time confounding may also occur in the presence of a nonspecific inhibitor (such as lupus anticoagulant).8 This would increase the risk of thrombosis and limb loss. Data supporting the efficacy of argatroban is limited to patients with suspected or confirmed HIT.8,9"}

{"project":"LitCovid-PD-MONDO","denotations":[{"id":"T91","span":{"begin":66,"end":69},"obj":"Disease"},{"id":"T92","span":{"begin":525,"end":528},"obj":"Disease"},{"id":"T93","span":{"begin":572,"end":575},"obj":"Disease"},{"id":"T94","span":{"begin":653,"end":663},"obj":"Disease"},{"id":"T95","span":{"begin":924,"end":948},"obj":"Disease"},{"id":"T96","span":{"begin":936,"end":948},"obj":"Disease"},{"id":"T97","span":{"begin":969,"end":977},"obj":"Disease"},{"id":"T98","span":{"begin":1088,"end":1093},"obj":"Disease"},{"id":"T99","span":{"begin":1143,"end":1153},"obj":"Disease"},{"id":"T100","span":{"begin":1263,"end":1266},"obj":"Disease"}],"attributes":[{"id":"A91","pred":"mondo_id","subj":"T91","obj":"http://purl.obolibrary.org/obo/MONDO_0018048"},{"id":"A92","pred":"mondo_id","subj":"T92","obj":"http://purl.obolibrary.org/obo/MONDO_0018048"},{"id":"A93","pred":"mondo_id","subj":"T93","obj":"http://purl.obolibrary.org/obo/MONDO_0018048"},{"id":"A94","pred":"mondo_id","subj":"T94","obj":"http://purl.obolibrary.org/obo/MONDO_0000831"},{"id":"A95","pred":"mondo_id","subj":"T95","obj":"http://purl.obolibrary.org/obo/MONDO_0001243"},{"id":"A96","pred":"mondo_id","subj":"T96","obj":"http://purl.obolibrary.org/obo/MONDO_0001531"},{"id":"A97","pred":"mondo_id","subj":"T97","obj":"http://purl.obolibrary.org/obo/MONDO_0100096"},{"id":"A98","pred":"mondo_id","subj":"T98","obj":"http://purl.obolibrary.org/obo/MONDO_0004670"},{"id":"A99","pred":"mondo_id","subj":"T99","obj":"http://purl.obolibrary.org/obo/MONDO_0000831"},{"id":"A100","pred":"mondo_id","subj":"T100","obj":"http://purl.obolibrary.org/obo/MONDO_0018048"}],"text":"The first step in the management of highly suspected or confirmed HIT is to stop heparin (including heparin flushes), and to initiate a non-heparin anticoagulant, to prevent thrombotic events, in the setting of ongoing massive thrombin generation.4 Available options for anticoagulation include argatroban, bivalirudin, danaparoid, fondaparinux, or a direct oral anticoagulant.6 Argatroban is a reversible inhibitor of thrombin5 with a short half-life and is not renally cleared. It is commonly used in the United States for HIT.4 In 2 multicenter trials of patients with HIT, argatroban resulted in reduced composite endpoint of death, amputation, and thrombosis, when compared with historic controls.5 A major concern with argatroban is potential under-anticoagulation in patients with elevated partial thromboplastin time, secondary to additional coagulopathies (hepatic dysfunction, prior anticoagulation with warfarin, consumptive coagulopathy, and more recently, COVID-19).4 Partial thromboplastin time confounding may also occur in the presence of a nonspecific inhibitor (such as lupus anticoagulant).8 This would increase the risk of thrombosis and limb loss. Data supporting the efficacy of argatroban is limited to patients with suspected or confirmed HIT.8,9"}

{"project":"LitCovid-PD-CLO","denotations":[{"id":"T84","span":{"begin":134,"end":135},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T85","span":{"begin":349,"end":350},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T86","span":{"begin":393,"end":394},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T87","span":{"begin":434,"end":435},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T88","span":{"begin":704,"end":705},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T89","span":{"begin":1055,"end":1056},"obj":"http://purl.obolibrary.org/obo/CLO_0001020"},{"id":"T90","span":{"begin":1158,"end":1162},"obj":"http://www.ebi.ac.uk/efo/EFO_0000876"}],"text":"The first step in the management of highly suspected or confirmed HIT is to stop heparin (including heparin flushes), and to initiate a non-heparin anticoagulant, to prevent thrombotic events, in the setting of ongoing massive thrombin generation.4 Available options for anticoagulation include argatroban, bivalirudin, danaparoid, fondaparinux, or a direct oral anticoagulant.6 Argatroban is a reversible inhibitor of thrombin5 with a short half-life and is not renally cleared. It is commonly used in the United States for HIT.4 In 2 multicenter trials of patients with HIT, argatroban resulted in reduced composite endpoint of death, amputation, and thrombosis, when compared with historic controls.5 A major concern with argatroban is potential under-anticoagulation in patients with elevated partial thromboplastin time, secondary to additional coagulopathies (hepatic dysfunction, prior anticoagulation with warfarin, consumptive coagulopathy, and more recently, COVID-19).4 Partial thromboplastin time confounding may also occur in the presence of a nonspecific inhibitor (such as lupus anticoagulant).8 This would increase the risk of thrombosis and limb loss. Data supporting the efficacy of argatroban is limited to patients with suspected or confirmed HIT.8,9"}

{"project":"LitCovid-PD-CHEBI","denotations":[{"id":"T41","span":{"begin":81,"end":88},"obj":"Chemical"},{"id":"T42","span":{"begin":100,"end":107},"obj":"Chemical"},{"id":"T43","span":{"begin":140,"end":147},"obj":"Chemical"},{"id":"T44","span":{"begin":148,"end":161},"obj":"Chemical"},{"id":"T45","span":{"begin":295,"end":305},"obj":"Chemical"},{"id":"T46","span":{"begin":307,"end":318},"obj":"Chemical"},{"id":"T47","span":{"begin":332,"end":344},"obj":"Chemical"},{"id":"T48","span":{"begin":363,"end":376},"obj":"Chemical"},{"id":"T49","span":{"begin":406,"end":415},"obj":"Chemical"},{"id":"T50","span":{"begin":577,"end":587},"obj":"Chemical"},{"id":"T51","span":{"begin":725,"end":735},"obj":"Chemical"},{"id":"T52","span":{"begin":914,"end":922},"obj":"Chemical"},{"id":"T53","span":{"begin":1069,"end":1078},"obj":"Chemical"},{"id":"T54","span":{"begin":1094,"end":1107},"obj":"Chemical"},{"id":"T55","span":{"begin":1201,"end":1211},"obj":"Chemical"}],"attributes":[{"id":"A41","pred":"chebi_id","subj":"T41","obj":"http://purl.obolibrary.org/obo/CHEBI_28304"},{"id":"A42","pred":"chebi_id","subj":"T42","obj":"http://purl.obolibrary.org/obo/CHEBI_28304"},{"id":"A43","pred":"chebi_id","subj":"T43","obj":"http://purl.obolibrary.org/obo/CHEBI_28304"},{"id":"A44","pred":"chebi_id","subj":"T44","obj":"http://purl.obolibrary.org/obo/CHEBI_50249"},{"id":"A45","pred":"chebi_id","subj":"T45","obj":"http://purl.obolibrary.org/obo/CHEBI_48720"},{"id":"A46","pred":"chebi_id","subj":"T46","obj":"http://purl.obolibrary.org/obo/CHEBI_59173"},{"id":"A47","pred":"chebi_id","subj":"T47","obj":"http://purl.obolibrary.org/obo/CHEBI_61033"},{"id":"A48","pred":"chebi_id","subj":"T48","obj":"http://purl.obolibrary.org/obo/CHEBI_50249"},{"id":"A49","pred":"chebi_id","subj":"T49","obj":"http://purl.obolibrary.org/obo/CHEBI_35222"},{"id":"A50","pred":"chebi_id","subj":"T50","obj":"http://purl.obolibrary.org/obo/CHEBI_48720"},{"id":"A51","pred":"chebi_id","subj":"T51","obj":"http://purl.obolibrary.org/obo/CHEBI_48720"},{"id":"A52","pred":"chebi_id","subj":"T52","obj":"http://purl.obolibrary.org/obo/CHEBI_10033"},{"id":"A53","pred":"chebi_id","subj":"T53","obj":"http://purl.obolibrary.org/obo/CHEBI_35222"},{"id":"A54","pred":"chebi_id","subj":"T54","obj":"http://purl.obolibrary.org/obo/CHEBI_50249"},{"id":"A55","pred":"chebi_id","subj":"T55","obj":"http://purl.obolibrary.org/obo/CHEBI_48720"}],"text":"The first step in the management of highly suspected or confirmed HIT is to stop heparin (including heparin flushes), and to initiate a non-heparin anticoagulant, to prevent thrombotic events, in the setting of ongoing massive thrombin generation.4 Available options for anticoagulation include argatroban, bivalirudin, danaparoid, fondaparinux, or a direct oral anticoagulant.6 Argatroban is a reversible inhibitor of thrombin5 with a short half-life and is not renally cleared. It is commonly used in the United States for HIT.4 In 2 multicenter trials of patients with HIT, argatroban resulted in reduced composite endpoint of death, amputation, and thrombosis, when compared with historic controls.5 A major concern with argatroban is potential under-anticoagulation in patients with elevated partial thromboplastin time, secondary to additional coagulopathies (hepatic dysfunction, prior anticoagulation with warfarin, consumptive coagulopathy, and more recently, COVID-19).4 Partial thromboplastin time confounding may also occur in the presence of a nonspecific inhibitor (such as lupus anticoagulant).8 This would increase the risk of thrombosis and limb loss. Data supporting the efficacy of argatroban is limited to patients with suspected or confirmed HIT.8,9"}

{"project":"LitCovid-sentences","denotations":[{"id":"T73","span":{"begin":0,"end":479},"obj":"Sentence"},{"id":"T74","span":{"begin":480,"end":1168},"obj":"Sentence"},{"id":"T75","span":{"begin":1169,"end":1270},"obj":"Sentence"}],"namespaces":[{"prefix":"_base","uri":"http://pubannotation.org/ontology/tao.owl#"}],"text":"The first step in the management of highly suspected or confirmed HIT is to stop heparin (including heparin flushes), and to initiate a non-heparin anticoagulant, to prevent thrombotic events, in the setting of ongoing massive thrombin generation.4 Available options for anticoagulation include argatroban, bivalirudin, danaparoid, fondaparinux, or a direct oral anticoagulant.6 Argatroban is a reversible inhibitor of thrombin5 with a short half-life and is not renally cleared. It is commonly used in the United States for HIT.4 In 2 multicenter trials of patients with HIT, argatroban resulted in reduced composite endpoint of death, amputation, and thrombosis, when compared with historic controls.5 A major concern with argatroban is potential under-anticoagulation in patients with elevated partial thromboplastin time, secondary to additional coagulopathies (hepatic dysfunction, prior anticoagulation with warfarin, consumptive coagulopathy, and more recently, COVID-19).4 Partial thromboplastin time confounding may also occur in the presence of a nonspecific inhibitor (such as lupus anticoagulant).8 This would increase the risk of thrombosis and limb loss. Data supporting the efficacy of argatroban is limited to patients with suspected or confirmed HIT.8,9"}

{"project":"LitCovid-PD-HP","denotations":[{"id":"T65","span":{"begin":66,"end":69},"obj":"Phenotype"},{"id":"T66","span":{"begin":525,"end":528},"obj":"Phenotype"},{"id":"T67","span":{"begin":572,"end":575},"obj":"Phenotype"},{"id":"T68","span":{"begin":850,"end":864},"obj":"Phenotype"},{"id":"T69","span":{"begin":936,"end":948},"obj":"Phenotype"},{"id":"T70","span":{"begin":1088,"end":1107},"obj":"Phenotype"},{"id":"T71","span":{"begin":1263,"end":1266},"obj":"Phenotype"}],"attributes":[{"id":"A65","pred":"hp_id","subj":"T65","obj":"http://purl.obolibrary.org/obo/HP_0011874"},{"id":"A66","pred":"hp_id","subj":"T66","obj":"http://purl.obolibrary.org/obo/HP_0011874"},{"id":"A67","pred":"hp_id","subj":"T67","obj":"http://purl.obolibrary.org/obo/HP_0011874"},{"id":"A68","pred":"hp_id","subj":"T68","obj":"http://purl.obolibrary.org/obo/HP_0003256"},{"id":"A69","pred":"hp_id","subj":"T69","obj":"http://purl.obolibrary.org/obo/HP_0003256"},{"id":"A70","pred":"hp_id","subj":"T70","obj":"http://purl.obolibrary.org/obo/HP_0025343"},{"id":"A71","pred":"hp_id","subj":"T71","obj":"http://purl.obolibrary.org/obo/HP_0011874"}],"text":"The first step in the management of highly suspected or confirmed HIT is to stop heparin (including heparin flushes), and to initiate a non-heparin anticoagulant, to prevent thrombotic events, in the setting of ongoing massive thrombin generation.4 Available options for anticoagulation include argatroban, bivalirudin, danaparoid, fondaparinux, or a direct oral anticoagulant.6 Argatroban is a reversible inhibitor of thrombin5 with a short half-life and is not renally cleared. It is commonly used in the United States for HIT.4 In 2 multicenter trials of patients with HIT, argatroban resulted in reduced composite endpoint of death, amputation, and thrombosis, when compared with historic controls.5 A major concern with argatroban is potential under-anticoagulation in patients with elevated partial thromboplastin time, secondary to additional coagulopathies (hepatic dysfunction, prior anticoagulation with warfarin, consumptive coagulopathy, and more recently, COVID-19).4 Partial thromboplastin time confounding may also occur in the presence of a nonspecific inhibitor (such as lupus anticoagulant).8 This would increase the risk of thrombosis and limb loss. Data supporting the efficacy of argatroban is limited to patients with suspected or confirmed HIT.8,9"}

{"project":"LitCovid-PubTator","denotations":[{"id":"347","span":{"begin":227,"end":235},"obj":"Gene"},{"id":"348","span":{"begin":419,"end":427},"obj":"Gene"},{"id":"349","span":{"begin":558,"end":566},"obj":"Species"},{"id":"350","span":{"begin":774,"end":782},"obj":"Species"},{"id":"351","span":{"begin":1226,"end":1234},"obj":"Species"},{"id":"352","span":{"begin":81,"end":88},"obj":"Chemical"},{"id":"353","span":{"begin":100,"end":107},"obj":"Chemical"},{"id":"354","span":{"begin":140,"end":147},"obj":"Chemical"},{"id":"355","span":{"begin":295,"end":305},"obj":"Chemical"},{"id":"356","span":{"begin":320,"end":330},"obj":"Chemical"},{"id":"357","span":{"begin":332,"end":344},"obj":"Chemical"},{"id":"358","span":{"begin":379,"end":389},"obj":"Chemical"},{"id":"359","span":{"begin":577,"end":587},"obj":"Chemical"},{"id":"360","span":{"begin":725,"end":735},"obj":"Chemical"},{"id":"361","span":{"begin":914,"end":922},"obj":"Chemical"},{"id":"362","span":{"begin":1201,"end":1211},"obj":"Chemical"},{"id":"363","span":{"begin":66,"end":69},"obj":"Disease"},{"id":"364","span":{"begin":174,"end":184},"obj":"Disease"},{"id":"365","span":{"begin":525,"end":528},"obj":"Disease"},{"id":"366","span":{"begin":572,"end":575},"obj":"Disease"},{"id":"367","span":{"begin":630,"end":635},"obj":"Disease"},{"id":"368","span":{"begin":653,"end":663},"obj":"Disease"},{"id":"369","span":{"begin":850,"end":864},"obj":"Disease"},{"id":"370","span":{"begin":866,"end":885},"obj":"Disease"},{"id":"371","span":{"begin":924,"end":948},"obj":"Disease"},{"id":"372","span":{"begin":969,"end":977},"obj":"Disease"},{"id":"373","span":{"begin":1143,"end":1153},"obj":"Disease"},{"id":"374","span":{"begin":1158,"end":1167},"obj":"Disease"},{"id":"375","span":{"begin":1263,"end":1266},"obj":"Disease"}],"attributes":[{"id":"A347","pred":"tao:has_database_id","subj":"347","obj":"Gene:2147"},{"id":"A348","pred":"tao:has_database_id","subj":"348","obj":"Gene:2147"},{"id":"A349","pred":"tao:has_database_id","subj":"349","obj":"Tax:9606"},{"id":"A350","pred":"tao:has_database_id","subj":"350","obj":"Tax:9606"},{"id":"A351","pred":"tao:has_database_id","subj":"351","obj":"Tax:9606"},{"id":"A352","pred":"tao:has_database_id","subj":"352","obj":"MESH:D006493"},{"id":"A353","pred":"tao:has_database_id","subj":"353","obj":"MESH:D006493"},{"id":"A354","pred":"tao:has_database_id","subj":"354","obj":"MESH:D006493"},{"id":"A355","pred":"tao:has_database_id","subj":"355","obj":"MESH:C031942"},{"id":"A356","pred":"tao:has_database_id","subj":"356","obj":"MESH:C035838"},{"id":"A357","pred":"tao:has_database_id","subj":"357","obj":"MESH:D000077425"},{"id":"A358","pred":"tao:has_database_id","subj":"358","obj":"MESH:C031942"},{"id":"A359","pred":"tao:has_database_id","subj":"359","obj":"MESH:C031942"},{"id":"A360","pred":"tao:has_database_id","subj":"360","obj":"MESH:C031942"},{"id":"A361","pred":"tao:has_database_id","subj":"361","obj":"MESH:D014859"},{"id":"A362","pred":"tao:has_database_id","subj":"362","obj":"MESH:C031942"},{"id":"A363","pred":"tao:has_database_id","subj":"363","obj":"MESH:D013921"},{"id":"A364","pred":"tao:has_database_id","subj":"364","obj":"MESH:D013927"},{"id":"A365","pred":"tao:has_database_id","subj":"365","obj":"MESH:D013921"},{"id":"A366","pred":"tao:has_database_id","subj":"366","obj":"MESH:D013921"},{"id":"A367","pred":"tao:has_database_id","subj":"367","obj":"MESH:D003643"},{"id":"A368","pred":"tao:has_database_id","subj":"368","obj":"MESH:D013927"},{"id":"A369","pred":"tao:has_database_id","subj":"369","obj":"MESH:D001778"},{"id":"A370","pred":"tao:has_database_id","subj":"370","obj":"MESH:D008107"},{"id":"A371","pred":"tao:has_database_id","subj":"371","obj":"MESH:D004211"},{"id":"A372","pred":"tao:has_database_id","subj":"372","obj":"MESH:C000657245"},{"id":"A373","pred":"tao:has_database_id","subj":"373","obj":"MESH:D013927"},{"id":"A374","pred":"tao:has_database_id","subj":"374","obj":"MESH:D017880"},{"id":"A375","pred":"tao:has_database_id","subj":"375","obj":"MESH:D013921"}],"namespaces":[{"prefix":"Tax","uri":"https://www.ncbi.nlm.nih.gov/taxonomy/"},{"prefix":"MESH","uri":"https://id.nlm.nih.gov/mesh/"},{"prefix":"Gene","uri":"https://www.ncbi.nlm.nih.gov/gene/"},{"prefix":"CVCL","uri":"https://web.expasy.org/cellosaurus/CVCL_"}],"text":"The first step in the management of highly suspected or confirmed HIT is to stop heparin (including heparin flushes), and to initiate a non-heparin anticoagulant, to prevent thrombotic events, in the setting of ongoing massive thrombin generation.4 Available options for anticoagulation include argatroban, bivalirudin, danaparoid, fondaparinux, or a direct oral anticoagulant.6 Argatroban is a reversible inhibitor of thrombin5 with a short half-life and is not renally cleared. It is commonly used in the United States for HIT.4 In 2 multicenter trials of patients with HIT, argatroban resulted in reduced composite endpoint of death, amputation, and thrombosis, when compared with historic controls.5 A major concern with argatroban is potential under-anticoagulation in patients with elevated partial thromboplastin time, secondary to additional coagulopathies (hepatic dysfunction, prior anticoagulation with warfarin, consumptive coagulopathy, and more recently, COVID-19).4 Partial thromboplastin time confounding may also occur in the presence of a nonspecific inhibitor (such as lupus anticoagulant).8 This would increase the risk of thrombosis and limb loss. Data supporting the efficacy of argatroban is limited to patients with suspected or confirmed HIT.8,9"}

{"project":"2_test","denotations":[{"id":"32720827-30482768-61488857","span":{"begin":377,"end":378},"obj":"30482768"},{"id":"32720827-28416511-61488858","span":{"begin":427,"end":428},"obj":"28416511"},{"id":"32720827-28416511-61488859","span":{"begin":702,"end":703},"obj":"28416511"},{"id":"32720827-25590528-61488860","span":{"begin":1109,"end":1110},"obj":"25590528"},{"id":"32720827-25590528-61488861","span":{"begin":1267,"end":1268},"obj":"25590528"},{"id":"32720827-21264902-61488862","span":{"begin":1269,"end":1270},"obj":"21264902"}],"text":"The first step in the management of highly suspected or confirmed HIT is to stop heparin (including heparin flushes), and to initiate a non-heparin anticoagulant, to prevent thrombotic events, in the setting of ongoing massive thrombin generation.4 Available options for anticoagulation include argatroban, bivalirudin, danaparoid, fondaparinux, or a direct oral anticoagulant.6 Argatroban is a reversible inhibitor of thrombin5 with a short half-life and is not renally cleared. It is commonly used in the United States for HIT.4 In 2 multicenter trials of patients with HIT, argatroban resulted in reduced composite endpoint of death, amputation, and thrombosis, when compared with historic controls.5 A major concern with argatroban is potential under-anticoagulation in patients with elevated partial thromboplastin time, secondary to additional coagulopathies (hepatic dysfunction, prior anticoagulation with warfarin, consumptive coagulopathy, and more recently, COVID-19).4 Partial thromboplastin time confounding may also occur in the presence of a nonspecific inhibitor (such as lupus anticoagulant).8 This would increase the risk of thrombosis and limb loss. Data supporting the efficacy of argatroban is limited to patients with suspected or confirmed HIT.8,9"}