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Increasing the Diagnostic Utility of Heparin-Induced Thrombocytopenia (HIT) Testing: An Academic Medical Center's Utilization Analysis and Intervention.
J Appl Lab Med
January 2025
Department of Pathology, University of Iowa Health Care, Iowa City, IA, United States.
Background: Heparin-induced thrombocytopenia (HIT) is a potentially life-threatening adverse drug reaction with numerous diagnostic challenges. Diagnosis of HIT begins with 4T score clinical assessment, followed by laboratory testing for those not deemed low risk. Laboratory testing for HIT includes screening [enzyme-linked immunosorbent assay (ELISA)] and confirmatory [serotonin release assay (SRA)] assays, wherein SRA testing can be pursued following a positive ELISA result.
View Article and Find Full Text PDFHeparin-induced thrombocytopenia (HIT) is an adverse drug reaction with significant thromboembolic risk. Though there are models for use of non-heparin anticoagulants, heparin remains the preferred anticoagulant in many operative settings, especially cardiovascular surgery and percutaneous cardiac intervention. The natural history of HIT can be stereotyped into phases using HIT laboratory testing to guide clinical management and determine whether heparin re-exposure can be considered.
View Article and Find Full Text PDFComplement activation as a biomarker for platelet activating antibodies in heparin-induced thrombocytopenia (HIT).
J Thromb Haemost
December 2024
Division of Hematology, Duke University Medical Center, Durham, NC. Electronic address:
Background: IgG antibodies (Abs) to platelet factor 4 complexed to heparin (PF4/H) commonly occur after heparin exposure but cause life-threatening complications of heparin-induced thrombocytopenia (HIT) in only a few patients. Presently, only platelet activation assays reliably distinguish anti-PF4/H Abs that cause disease (HIT Abs) from those likely to be asymptomatic (AAbs).
Objectives: Recent studies indicate that complement activation is an important serologic property of HIT Abs and is essential for FcγRIIA-mediated cellular activation.
In-Hospital and Midterm Outcomes of Lead Extraction: A Single-Center Clinical Study.
J Tehran Heart Cent
January 2024
Department of Cardiac Electrophysiology, Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Background: The rate of lead extraction has steadily increased alongside the extensive use of cardiovascular implantable electronic devices. Data on the complications and safety of this challenging procedure are limited. We investigated inhospital and midterm outcomes following lead extraction.
View Article and Find Full Text PDFAortic Thrombus Formation in the Mixing Zone of a Patient With Acute Myocarditis.
JACC Case Rep
November 2024
Cardiovascular Division, Osaka Police Hospital, Osaka, Japan.
A 66-year-old man presented with chills, exertional dyspnea, and palpitations; he later developed a fever. Because of his elevated cardiac enzymes and electrocardiography and coronary angiography findings, he was diagnosed with acute myocarditis. Given his unstable hemodynamics, an intra-aortic balloon pump was inserted; however, he experienced a hemodynamic collapse due to refractory ventricular fibrillation.
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