Progressive, Fatal Thrombosis Associated with Heparin-Induced Thrombocytopenia after Cardiac Surgery Despite "therapeutic" Anticoagulation with Argatroban: Potential Role for PTT and ACT Confounding

From the *Department of Pharmaceutical Services, Beaumont Hospital, Royal Oak, MI; †Department of Pharmacy Practice, Wayne State University, Detroit, MI; ‡Department of Pathology and Molecular Medicine, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada; §Department of Clinical Pathology, Beaumont Hospital, Royal Oak, MI; and ¶Cardiovascular Research and Quality Programs, Ernst Cardiovascular Center, Beaumont Hospital, Royal Oak, MI. Address reprint requests to Maureen A. Smythe, PharmD, Department of Pharmacy Practice, Wayne State University, 259 Mack Avenue, Suite 2190, Detroit, MI 28202. E-mail: msmythe@beaumont.edu © 2015 Elsevier Inc. All rights reserved. 1053-0770/2602-0033$36.00/0 http://dx.doi.org/10.1053/j.jvca.2014.04.029