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Outcome of patients with positive heparin-platelet factor-4 antibodies: A retrospective multi-institutional observational study.
[heparin-induced thrombocytopenia]
Abstract
Studies
show
increased
mortality
with
positive
heparin-
platelet
factor
-
4
(
H-
PF
4
)
antibodies
,
especially
in
hemodialysis
patients
.
We
aimed
to
compare
mortality
and
thrombosis
in
hospitalized
patients
with
positive
,
equivocal
and
negative
H-
PF
4
antibody
results
.
Information
was
collected
on
these
patients
using
a
multi-institutional
retrospective
electronic
medical
record
review
.
Patients
tested
for
H-
PF
4
antibodies
by
commercial
ELISA
during
the
years
2006
to
2010
were
identified
.
We
compared
30
-
day
,
90
-
day
and
1
-
year
mortality
in
patients
with
negative
,
equivocal
and
positive
H-
PF
4
test
and
evaluated
the
relationship
between
H-
PF
4
status
and
rate
of
thrombosis
.
Four
hundred
and
seventeen
patients
had
ELISA
testing
for
H-
PF
4
antibodies
.
Forty
-
four
patients
had
equivocal
(
optical
density
value
0
.
4
-
0
.
9
)
and
21
had
positive
(
value
1
)
H-
PF
4
antibody
test
.
There
were
no
statistically
significant
differences
in
mortality
between
patients
with
negative
,
equivocal
and
positive
results
at
all
three
time
points
(
p
 
=
 
0
.
22
,
0
.
27
and
0
.
38
,
respectively
)
even
after
excluding
patients
with
thrombosis
(
p
 
=
 
0
.
22
,
0
.
24
and
0
.
31
,
respectively
)
.
Age
and
Charlson
score
were
associated
with
increased
30
-
day
,
90
-
day
and
1
year
mortality
.
Odds
ratio
of
having
thrombosis
was
23
.
1
for
positive
vs
.
equivocal
results
(
p
 
<
 
0
.
001
)
;
however
,
there
was
no
statistically
significant
difference
between
equivocal
vs
.
negative
results
(
p
 
=
 
0
.
22
)
.
Our
results
revealed
no
association
between
H-
PF
4
status
and
mortality
,
as
well
as
no
difference
in
1
-
year
survival
between
the
positive
and
negative
groups
.
Diseases
Validation
Diseases presenting
"positive vs"
symptom
esophageal carcinoma
heparin-induced thrombocytopenia
liposarcoma
well-differentiated liposarcoma
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