Heparin-induced thrombocytopenia risk factors: Difference between revisions
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* Type of patient: surgical patients are at higher risk than medical; cardiac surgical patients have the highest risk of all.<ref name="pmid23714311">{{cite journal| author=Lee GM, Arepally GM| title=Diagnosis and management of heparin-induced thrombocytopenia. | journal=Hematol Oncol Clin North Am | year= 2013 | volume= 27 | issue= 3 | pages= 541-63 | pmid=23714311 | doi=10.1016/j.hoc.2013.02.001 | pmc=3668315 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23714311 }} </ref> This is though to be related to differences in basal level of circulating [[platelet factor 4]] (PF4) and platelet activation in these various populations. | * Type of patient: surgical patients are at higher risk than medical; cardiac surgical patients have the highest risk of all.<ref name="pmid23714311">{{cite journal| author=Lee GM, Arepally GM| title=Diagnosis and management of heparin-induced thrombocytopenia. | journal=Hematol Oncol Clin North Am | year= 2013 | volume= 27 | issue= 3 | pages= 541-63 | pmid=23714311 | doi=10.1016/j.hoc.2013.02.001 | pmc=3668315 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23714311 }} </ref> This is though to be related to differences in basal level of circulating [[platelet factor 4]] (PF4) and platelet activation in these various populations. | ||
* There is no increase in risk of HIT with genetic risk factors for thrombosis such as [[factor V Leiden]], [[prothrombin]] gene mutation, [[methylenetetrahydrofolate reductase]] ([[MTHFR]]) polymorphism and platelet-receptor polymorphisms. | * There is no increase in risk of HIT with genetic risk factors for thrombosis such as [[factor V Leiden]], [[prothrombin]] gene mutation, [[methylenetetrahydrofolate reductase]] ([[MTHFR]]) polymorphism and platelet-receptor polymorphisms. | ||
* Sex: Females have a higher risk than males. The odds ratio (OR) is 2.4:1.<ref name="pmid23714311">{{cite journal| author=Lee GM, Arepally GM| title=Diagnosis and management of heparin-induced thrombocytopenia. | journal=Hematol Oncol Clin North Am | year= 2013 | volume= 27 | issue= 3 | pages= 541-63 | pmid=23714311 | doi=10.1016/j.hoc.2013.02.001 | pmc=3668315 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23714311 }} </ref> | * Sex: Females have a higher risk than males. The odds ratio (OR) is 2.4:1.<ref name="pmid23714311">{{cite journal| author=Lee GM, Arepally GM| title=Diagnosis and management of heparin-induced thrombocytopenia. | journal=Hematol Oncol Clin North Am | year= 2013 | volume= 27 | issue= 3 | pages= 541-63 | pmid=23714311 | doi=10.1016/j.hoc.2013.02.001 | pmc=3668315 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23714311 }} </ref> | ||
* Race: African Americans are more prone to HIT than Caucasians.<ref name="pmid23714311">{{cite journal| author=Lee GM, Arepally GM| title=Diagnosis and management of heparin-induced thrombocytopenia. | journal=Hematol Oncol Clin North Am | year= 2013 | volume= 27 | issue= 3 | pages= 541-63 | pmid=23714311 | doi=10.1016/j.hoc.2013.02.001 | pmc=3668315 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23714311 }} </ref> | * Race: African Americans are more prone to HIT than Caucasians.<ref name="pmid23714311">{{cite journal| author=Lee GM, Arepally GM| title=Diagnosis and management of heparin-induced thrombocytopenia. | journal=Hematol Oncol Clin North Am | year= 2013 | volume= 27 | issue= 3 | pages= 541-63 | pmid=23714311 | doi=10.1016/j.hoc.2013.02.001 | pmc=3668315 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23714311 }} </ref> | ||
'''Protective''' risk factors include: | '''Protective''' risk factors include: | ||
* Use of low molecular weight heparin | * Type of warfarin: Use of low molecular weight heparin such as enoxaparin carries a lower risk for HIT. | ||
* Type of patient: Pediatric or obstetric patients have a lower risk than medical or surgical patients | * Type of patient: Pediatric or obstetric patients have a lower risk for HIT than medical or surgical patients. | ||
==Reference== | ==Reference== | ||
Revision as of 21:55, 6 July 2017
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Heparin-induced thrombocytopenia |
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Differentiating Heparin-induced thrombocytopenia from other Diseases |
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Diagnosis |
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Treatment |
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Case Studies |
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Heparin-induced thrombocytopenia risk factors On the Web |
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American Roentgen Ray Society Images of Heparin-induced thrombocytopenia risk factors |
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Directions to Hospitals Treating Heparin-induced thrombocytopenia |
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Risk calculators and risk factors for Heparin-induced thrombocytopenia risk factors |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Aric C. Hall, M.D., [3] Shyam Patel [4]
Overview
Heparin-induced thrombocytopenia is diagnosed when the platelet count falls by > 50% typically after 5-10 days of heparin therapy. Increased risks for heparin-induced thrombocytopenia depends on type of heparin (unfractionated heparin > low molecular weight heparin), duration of therapy, females and type of patients (commoner in surgical patients that require large amount of heparin)
Risk factors
Adverse risk factors include:[1]
- Duration of heparin treatment: long duration, up to 2 weeks is associated with the greatest risk.
- Type of heparin: unfractionated heparin (UFH) has a greater risk than low molecular weight heparin (LMWH.
- Type of patient: surgical patients are at higher risk than medical; cardiac surgical patients have the highest risk of all.[2] This is though to be related to differences in basal level of circulating platelet factor 4 (PF4) and platelet activation in these various populations.
- There is no increase in risk of HIT with genetic risk factors for thrombosis such as factor V Leiden, prothrombin gene mutation, methylenetetrahydrofolate reductase (MTHFR) polymorphism and platelet-receptor polymorphisms.
- Sex: Females have a higher risk than males. The odds ratio (OR) is 2.4:1.[2]
- Race: African Americans are more prone to HIT than Caucasians.[2]
Protective risk factors include:
- Type of warfarin: Use of low molecular weight heparin such as enoxaparin carries a lower risk for HIT.
- Type of patient: Pediatric or obstetric patients have a lower risk for HIT than medical or surgical patients.
Reference
- ↑ Warkentin TE, Sheppard JA, Sigouin CS, Kohlmann T, Eichler P, Greinacher A. Gender imbalance and risk factor interactions in heparin-induced thrombocytopenia. Blood 2006;108:2937-41. PMID 16857993.
- ↑ 2.0 2.1 2.2 Lee GM, Arepally GM (2013). "Diagnosis and management of heparin-induced thrombocytopenia". Hematol Oncol Clin North Am. 27 (3): 541–63. doi:10.1016/j.hoc.2013.02.001. PMC 3668315. PMID 23714311.