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Differences in the clinical course of heparin induced thrombocytopenia before and after the availability of HIT IgG class testing.
[heparin-induced thrombocytopenia]
To
determine
whether
the
HIT
IgG
class
platelet
factor
4
(
PF
4
)
enzyme
immunoabsorbant
assay
(
EIA
)
influenced
the
duration
of
parenteral
direct
thrombin
inhibitor
(
pDTI
)
therapy
or
bleeding
risk
in
patients
started
on
pDTI
for
a
presumed
diagnosis
of
HIT
.
187
patients
started
on
pDTI
for
presumed
HIT
were
assessed
in
two
time
periods
before
(
period
1
,
n
=
88
patients
)
and
after
the
introduction
of
an
IgG-
specific
assay
(
period
2
,
n
=
99
patients
)
.
Patients
in
period
2
were
treated
with
pDTI
therapy
for
a
median
of
5
days
less
(
p
<
0
.
0001
)
however
the
incidence
of
Grade
III
and
IV
bleeding
episodes
was
not
different
.
Bleeding
was
observed
to
occur
early
during
the
hospital
course
at
a
median
of
2
-
3
days
after
initiation
of
the
pDTI
.
The
average
pDTI
drug
acquisition
cost
was
markedly
decreased
in
period
2
when
compared
to
period
1
(
p
<
0
.
0001
)
.
Implementation
of
the
IgG
class
HIT
EIA
resulted
in
a
decrease
in
the
number
of
days
on
a
pDTI
and
a
decrease
in
the
average
pDTI
acquisition
cost
per
patient
without
an
observed
change
in
serious
bleeding
events
.
