Heparin-induced thrombocytopenia risk factors

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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. 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

  • 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.[1]
    • 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.

Reference

  1. 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.

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