Abstract
Little is known about heparin-induced thrombocytopenia (HIT), a pro-thrombotic, potentially life-threatening immune-mediated reaction to heparin exposure, in conservative and interventional cardiovascular medicine. The 4T score, validated for prediction of HIT in surgical patients before, is also suitable for assessing HIT probability in cardiovascular patients with unclear thrombocytopenia. A total of 403 consecutive patients from our Department of Cardiology, Angiology and Pneumology in whom a HIT screening test was performed between 2009 and 2016 were identified. All 72 patients with a positive screening test were subjected to a functional confirmation test (heparin-induced platelet activation test, HIPA), resulting in 23 patients with serologically confirmed HIT (positive screening test, positive HIPA) and 49 patients with nonconfirmed HIT (positive screening test, negative HIPA). The 4TScore had a sensitivity of 82.6% and a specificity of 28.6% in our patients, suggesting that it might not sufficiently predict the clinical probability of HIT in cardiovascular patients. In both confirmed and nonconfirmed HIT, intrahospital mortality was high without a significant difference (30% in confirmed HIT vs 43% in nonconfirmed HIT)....Continue Reading
References
Jul 1, 1996·Intensive Care Medicine·J L VincentL G Thijs
Jan 13, 1999·Circulation·A GreinacherB Pötzsch
Oct 10, 2006·European Heart Journal·Irene Chung, Gregory Y H Lip
May 10, 2007·Journal of Thrombosis and Haemostasis : JTH·A GreinacherT E Warkentin
Aug 10, 2007·The New England Journal of Medicine·Richard H Aster, Daniel W Bougie
Jan 23, 2008·Der Anaesthesist·J T LutzK Görlinger
Oct 2, 2009·Journal of Thrombosis and Haemostasis : JTH·S SellengA Greinacher
Oct 13, 2009·Journal of Thrombosis and Haemostasis : JTH·Y Gruel, C Pouplard
Feb 13, 2010·Journal of Critical Care·Mark Andrew CrowtherUNKNOWN Canadian Critical Care Trials Group
Nov 13, 2010·Chest·Phil HuiDonald M Arnold
Aug 4, 2011·Journal of Thrombosis and Haemostasis : JTH·T E Warkentin
Jan 17, 2012·Blood·Adam Cuker, Douglas B Cines
Feb 15, 2012·Chest·Lori-Ann LinkinsMark Crowther
Sep 4, 2012·Blood·Krystin KrauelSven Hammerschmidt
Jul 9, 2013·Thrombosis Research·Georgios PongasPerumal Thiagarajan
Dec 4, 2013·Journal of Cardiothoracic and Vascular Anesthesia·Matthew SeigermanJoanna Chikwe
Mar 26, 2014·The Annals of Pharmacotherapy·David R WilliamsonDanielle Pilon
Apr 15, 2014·Journal of Critical Care·Mark CrowtherUNKNOWN Australian and New Zealand Intensive Care Society Clinical Trials Group
Dec 30, 2014·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Maral BaghaiBarbara Zieger
Feb 13, 2016·Heart, Lung & Circulation·Mohammad Khalid MojadidiRonald Zolty
Feb 24, 2016·JAMA : the Journal of the American Medical Association·Mervyn SingerDerek C Angus
Apr 12, 2016·Journal of Thrombosis and Haemostasis : JTH·L A LinkinsM A Crowther
Jun 16, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Dimitri ArangalageDavid Messika-Zeitoun
Aug 18, 2016·International Journal of Cardiology·Carolina Devesa-CorderoFrancisco Fernández-Avilés
Oct 1, 2016·Thrombosis Research·Evangelos K OikonomouPolydoros N Kampaktsis
Jun 4, 2017·The American Journal of Cardiology·Tesfaye TelilaLuis Afonso
Jun 25, 2017·Blood·Theodore E WarkentinLori-Ann Linkins