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Low prevalence of heparin-induced thrombocytopenia after cardiac surgery in Thai patients.
[heparin-induced thrombocytopenia]
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
(
PF
4
)
/
heparin
antibodies
,
HIT
,
and
its
thrombotic
complications
in
Thai
patients
undergoing
cardiac
surgery
using
unfractionated
heparin
.
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
PF
4
/
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
.
No
patient
had
detectable
anti-
PF
4
/
heparin
antibodies
at
baseline
.
Five
patients
sero-converted
during
the
course
of
the
study
for
anti-
PF
4
/
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-
PF
4
/
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
PF
4
/
heparin
antibody
tests
.
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-
PF
4
/
heparin
antibodies
and
clinical
HIT
than
previously
published
studies
.
Diseases
Validation
Diseases presenting
"thrombocytopenia after the operation"
symptom
heparin-induced thrombocytopenia
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