Heparin-Induced Thrombocytopenia
Pathophysiology
Heparin-induced immune thrombocytopenia.
Babcock RB, Dumper CW, Scharfman WB.
N Eng J Med. 295:237-241.
Description: Report of 5 patients who developed heparin-induced thrombocytopenia, with the detection of antibodies suggesting an immune etiology.
PubMed citation number: 945459
Antibodies from patients with heparin-induced thrombocytopenia/thrombosis are specific for platelet factor 4 complexed with heparin or bound to endothelial cells.
Visentin GP, Ford SE, Scott JP, Ashter RH.
J Clin Invest. 1994;93:81-88.
Description: Identifies antibody to platelet factor 4 complexed with heparin as etiology of platelet activation in patients with HIT.
PubMed citation number: 8282825
Heparin-associated thrombocytopenia: isolation of the antibody and characterization of multimolecular PF-4-heparin complex as the major antigen.
Greinacher A, Potzsch B, Amiral J, Dummel V, Eichener A, Mueller-Eckhardt C.
Thromb Haemost. 1994;71:247-251.
Description: Sera from 34 patients is used to identify antibodies to platelet factor 4 and correlate well with serotonin release assay for diagnosis of HIT.
PubMed citation number: 8191407
Temporal aspects of heparin-induced thrombocytopenia.
Warkentin TE, Kelton JG.
N Eng J Med. 2001;344:1286-1292.
Description: Describes characteristics that effect variations in the temporal onset of HIT.
PubMed citation number: 11320387
Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin.
Warkentin TE, Levine MN, Hirsh J, et al.
N Eng J Med. 332:1330-1335.
Description: Low-molecular-weight heparin has a lower incidence of HIT associated with thrombosis than with unfractioned heparin.
PubMed citation number: 7715641
A 14-year study of heparin-induced thrombocytopenia.
Warkentin TE, Kelton JG.
Am J Med. 1996;101:502-507.
Description: Retrospective review of risk and type of thrombosis in patients diagnosed with HIT.
PubMed citation number: 8948273
Ultralarge complexes of PF4 and heparin are central to the pathogenesis of heparin induced thrombocytopenia
Rauova L, Poncz M, McKenzie SE, et al.
Blood. 2005;105:131-138.
Description: Describes the pathogenesis of HIT, with ultralarge complexes of heparin and tetamers of platelet factor 4 seen on electron microscopy and using mutations studies.
PubMed citation number: 15304392
The homozygous FcgammaRIIIa-158V genotype is a risk factor for heparin induced thrombocytopenia in patients with antibodies to heparin-platelet factor 4 complexes.
Gruel Y, Pouplard C, Lasne D, Magdelaine-Beuzelin C, Charroing C, Watier H.
Blood. 2004;104:2791-2793.
Description: Prospective analysis of genotype of FcgammaRIIIa from blood of control patients receiving heparin and patients with confirmed heparin induced thrombocytopenia.
PubMed citation number: 15191947
Diagnosis
A diagnostic test for heparin-induced thrombocytopenia.
Sheridan D, Carter C, Kelton JG.
Blood. 1986;67:27-30.
Description: Describes development of the serotonin release assay, the gold standard for the diagnosis of heparin-induced thrombocytopenia.
PubMed citation number: 3940551
First workshop for detection of heparin-induced antibodies: validation of the heparin-induced platelet-activation test (HIPA) in comparison with a PF4/heparin ELISA.
Eichler P, Budde U, Haas S, et al.
Thromb Haemost. 1999;81:625-629.
Description: Reviews characteristics of diagnostic tests for HIT.
PubMed citation number: 10235451
Treatment
Failure of early heparin cessation as treatment for heparin induced thrombocytopenia.
Wallis DE, Workman DL, Lewis BE, Steen L, Pifarre R, Moran JF.
Am J Med. 1999;106:629-635.
Description: Retrospective review of risk of thrombosis and death in patients who developed HIT and were treated with heparin cessation alone.
PubMed citation number: 10378620
A comparison of danaparoid and lepirudin in heparin-induced thrombocytopenia.
Farner B, Eichler P, Kroll H, Greinacher A.
Thromb Haemost. 2001;85:950-957.
Description: Retrospective review of patients with HIT that were treated with either danaparoid or lepirudin, with primary outcome of new thromboembolic events, amputations, death, or major bleeding.
PubMed citation number: 11434701
Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia.
Lewis BE, Wallis DE, Berkowtiz SD, et al.
Circulation. 2001;103:1838-1843.
Description: Prospective study investigating the safety and efficacy of argatroban in patients with HIT or HIT associated with thrombosis (HITT).
PubMed citation number: 11294800
The anticoagulant therapy with bivalirudin to assist in the performance of percutaneous coronary intervention in patients with heparin-induced thrombocytopenia (ATBAT) study: more results.
Mahaffey KW, Lewis BE, Wildermann NM, et al.
J Invasive Cardiol. 2003;15:611-616.
Description: Prospective study of the safety and efficacy of bivalrudin in patients with a history of HIT or HITT undergoing percutaneous coronary intervention.
PubMed citation number: 14608128
Review
Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the seventh ACCP conference on antithrombotic and thrombolytic therapy.
Warkentin TE, Greinacher A.
Chest. 2005;126:311s-337s.
Description: Review and ACCP recommendations for the diagnosis, treatment, and prevention of HIT.
PubMed citation number: 15383477