Heparin-induced thrombocytopenia risk factors

Heparin-induced thrombocytopenia
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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]

Overview

Heparin-induced thrombocytopenia is diagnosed when the platelet count falls by > 50% typically after 5-10 days of heparin therapy.

Risk factors

• Genetic risk factors for thrombosis such as factor V Leiden, prothrombin gene mutation, methylenetetrahydrofolate reductase (MTHFR) polymorphism and platelet-receptor polymorphisms do not increase the risk of developing HIT associated thrombosis.
• Factors that affect the risk of developing HIT are noted as follows.
  • Duration of heparin treatment; long duration, up to 2 weeks is associated with the greatest risk.
  • The type of heparin involved; unfractionated heparinUFH has a greater risk than low molecular weight heparin LMWH.
  • The type of patient; surgical patients are at higher risk than medical; cardiac surgical patients have the highest risk of all.
  • Females have a higher risk.