Publication: Low prevalence of heparin-induced thrombocytopenia after cardiac surgery in Thai patients
Issued Date
2014-11-01
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ISSN
18792472
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2-s2.0-85028206513
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Mahidol University
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SCOPUS
Bibliographic Citation
Thrombosis research. Vol.134, No.5 (2014), 957-962
Suggested Citation
Kochawan Boonyawat, Pantep Angchaisuksiri, Katcharin Aryurachai, Suchart Chaiyaroj, Zohra Ahmadi, Beng H.ock Chong Low prevalence of heparin-induced thrombocytopenia after cardiac surgery in Thai patients. Thrombosis research. Vol.134, No.5 (2014), 957-962. doi:10.1016/j.thromres.2014.08.020 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/34170
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Title
Low prevalence of heparin-induced thrombocytopenia after cardiac surgery in Thai patients
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Abstract
Copyright © 2014 Elsevier Ltd. All rights reserved. INTRODUCTION: Heparin induced-thrombocytopenia (HIT) has been well recognized in Western countries. However, there are no data in the Thai population. We therefore investigated the prevalence of anti-platelet factor 4 (PF4)/heparin antibodies, HIT, and its thrombotic complications in Thai patients undergoing cardiac surgery using unfractionated heparin.MATERIALS AND METHODS: Seventy-three consecutive patients were prospectively enrolled in this study. Blood samples before operation and week 1, week 2, and week 3 after operation were collected from each patient for HIT antibody screening by enzyme-linked immunosorbent assay using IgG antibody specific to the PF4/heparin complex. Positive samples were further analyzed by (14)C-serotonin release assay. Complete blood count was performed daily during the first week, then weekly for 3 weeks.RESULTS: No patient had detectable anti-PF4/heparin antibodies at baseline. Five patients sero-converted during the course of the study for anti-PF4/heparin IgG: 3 (4.1%) at week 1, 4 (5.5%) at week 2, and 5 (6.8%) at week 3 after surgery. However, none of these patients had anti-PF4/heparin antibodies that resulted in (14)C-serotonin release to be considered clinically significant antibodies. Post-operative thrombocytopenia after the operation was found in 35 patients (47.9%), but was not considered to be caused by HIT. Thromboembolic events occurred in 3 patients (4.1%) during follow up; however, none of these patients had positive PF4/heparin antibody tests.CONCLUSIONS: Our study represents the first study to examine Thai patients exposed to heparin in the context of cardiac surgery. We found a lower prevalence of positive anti-PF4/heparin antibodies and clinical HIT than previously published studies.