Background: Heparin-induced thrombocytopenia is characterized by the presence of heparin-induced antibodies against heparin/platelet factor-4 (PF4) complex and paradoxical thrombosis. Little is known on the persistence of antiheparin antibodies in blood. The aim of this study was to evaluate the time course of heparin/PF4 antibodies in patients exposed to heparin.
Methods: We initially enrolled 500 patients treated with unfractionated heparin as part of perioperative management of coronary artery bypass graft; those who developed serologically confirmed heparin/PF4 antibodies were selected for further follow-up. Over 3 years, we repeatedly assessed serum concentration of antibodies (by enzyme-linked immunosorbent assay) and occurrence of thrombotic events.
Results: One hundred thirty-one patients (26.2%) developed anti-PF4/heparin antibodies, which persisted for a median time of 90 days (Quartile 1-Quartile 3, 31-186). At 30 days, patients with antibodies had higher incidence of thrombotic events (28.2% vs 14.9%, P < .01) and death/myocardial infarction (14.5% vs 7.8%, P < .001). Of the 131 patients with antiheparin/PF4 antibodies, 78 had already developed antibodies before cardiac surgery; such patients became serologically negative more slowly than patients who developed antibodies after surgery. Over 3 years of follow-up, patients with anti-PF4/heparin antibodies developed 65 thrombotic events, 25 patients developed deep vein thrombosis and/or pulmonary embolism, and 20 patients myocardial infarction.
Conclusions: Patients with heparin-induced antibodies are more likely to develop thrombosis after cardiac surgery. Patients in whom antibodies are present before surgery show longer persistence of antibodies and increased incidence of thrombotic events over time. Persistence of antibodies suggests that these patients may be at risk for developing thrombosis; and therefore, further exposure to heparin should be limited.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ahj.2008.11.007 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Steatohepatitis-induced vascular niche alterations promote melanoma metastasis.
Cancer Metab
January 2025
Department of Dermatology, Venereology and Allergology, University Medical Center and Medical Faculty Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany.
Background: In malignant melanoma, liver metastases significantly reduce survival, even despite highly effective new therapies. Given the increase in metabolic liver diseases such as metabolic dysfunction-associated steatotic liver disease (MASLD) and metabolic dysfunction-associated steatohepatitis (MASH), this study investigated the impact of liver sinusoidal endothelial cell (LSEC)-specific alterations in MASLD/MASH on hepatic melanoma metastasis.
Methods: Mice were fed a choline-deficient L-amino acid-defined (CDAA) diet for ten weeks to induce MASH-associated liver fibrosis, or a CDAA diet or a high fat diet (HFD) for shorter periods of time to induce early steatosis-associated alterations.
Enhancing surveillance for dengue fever in Oyo State, Nigeria - a one health approach.
One Health Outlook
January 2025
Medical Virology Unit, Faculty of Basic Medical and Applied Sciences, Lead City University and Primary Health Care Board, Ibadan, Oyo State, Nigeria.
Background: Dengue fever (DF) poses a growing global threat, necessitating a comprehensive one-health approach to address its complex interplay between human, animal, and environmental factors. In Oyo State, Nigeria, the true burden of DF remains unknown due to underdiagnosis and misdiagnosis as malaria, exacerbated by poor health-seeking behavior, weak surveillance systems, and inadequate health infrastructure. Adopting a one-health approach is crucial to understanding the dynamics of DF transmission.
View Article and Find Full Text PDFLevilactobacillus brevis CD2 as a multifaceted probiotic to preserve oral health: results of a double-blind, randomized, placebo-controlled trial in healthy adults.
J Transl Med
January 2025
Department of Life, Health & Environmental Sciences, University of L'Aquila, Building Rita Levi Montalcini, Coppito, L'Aquila, 67100, Italy.
Background: A growing number of in vitro and in vivo studies suggest the application of probiotics as a natural approach to maintaining oral health. This double-blind, randomized controlled trial aimed to evaluate the efficacy of Levilactobacillus brevis CD2 (CNCM I-5566), a multifunctional probiotic frequently used in oral medicine, in preserving or improving several recognized oral health indicators.
Methods: Thirty consenting healthy adults were randomized to receive four lozenges per day of L.
Correction: Vertebral artery dissection in a patient with migraine treated with calcitonin gene-related peptide monoclonal antibody: a case report and FAERS database analysis.
BMC Neurol
January 2025
Department of Neurology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
Comparison of the epidemiological characteristics of mycoplasma pneumoniae infections among children during two epidemics in Wuhan from 2018 to 2024.
BMC Pediatr
January 2025
Department of Pulmonary and Critical Care Medicine, Renmin Hospital of Wuhan University Wuhan, Hubei, China.
Background: Mycoplasma pneumoniae (M pneumoniae, MP) is a common pathogen causing respiratory tract infections, particularly in children. In 2023, a resurgence of MP epidemics was observed in Wuhan, Hubei Province, China. This study aims to examine the epidemiological trends and clinical characteristics of MP infections among children in Wuhan from 2018 to 2024, providing valuable scientific evidence to guide local prevention strategies.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!