Anticoagulation selection in acute HIT. Options for anticoagulation in acute HIT are guided by 4 clinical criteria. A green check indicates the agent is preferred. A yellow exclamation point indicates the agent is not preferred but can be used with caution based on availability and consideration of the balance of risks and benefits. A red X indicates the agent is not recommended. *Existing data with rivaroxaban, apixaban; ^If argatroban not available, can use with close monitoring due to accumulation risk; °Trivial risk of reported HIT, but safe use in acute HIT is well-documented³¹; ~Use in renal dysfunction has been reported.⁴³ Bili, bilirubin; CrCl, creatinine clearance; IV, intravenous; SQ, subcutaneous. Adapted with permission from May et al.³⁸