Abstract
The clinical effects of heparin are meritorious and heparin remains the anticoagulant of choice for most clinical needs. However, as with any drug, adverse effects exist. Heparin-induced thrombocytopenia (HIT) is an important adverse effect of heparin associated with amputation and death due to thrombosis. Although the diagnosis and treatment of HIT can be difficult and complex, it is critical that patients with HIT be identified as soon as possible to initiate early treatment to avoid thrombosis.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kelton, J.G., Sheridan, D., Santos, A., Smith, J., Steeves, K., Smith, C., Brown, C., and Murphy, W.G. (1988) Heparin-induced thrombocytopenia: laboratory studies Blood 72, 925–30.
Amiral, J., Bridey, F., Dreyfus, M., Vissac, M., Fressinaud, E., Wolf, M., and Meyer, D. (1992) Platelet factor 4 complexed to heparin is the target for antibodies generated in heparin-induced thrombocytopenia Thromb Haemost 68, 95–6.
Greinacher, A., Potzsch, B., Amiral, J., Dummel, V., Eichner, A., and Mueller-Eckhardt, C. (1994) Heparin-associated thrombocytopenia: isolation of the antibody and characterization of a multimolecular PF4-heparin complex as the major antigen Thromb Haemost 71, 247–51.
Maccarana, M., and Lindahl, U. (1993) Model of interaction between platelet factor 4 and heparin Glycobiology 3, 271–7.
Mayo, K.H., Ilyina, E., Roongta, V., Dundas, M., Joseph, J., Lai, C.K., Maione, T., and Daly, T.J. (1995) Heparin binding to platelet factor-4. An NMR and site-directed .mutagenesis study: arginine residues are crucial for binding Biochem J 312, 357–65.
Newman, P.M., and Chong, B.H. (2000) Heparin-induced thrombocytopenia: new evidence for the dynamic binding of purified anti-PF4-heparin antibodies to platelets and the resultant platelet activation Blood 96, 182–7.
Suh, J., Aster, R.H., and Visentin, G.P. (1998) Antibodies from patients with heparin-induced thrombocytopenia/throm bosis recognize different epitopes on heparin:platelet factor 4 Blood 91, 916–22.
Visentin, G.P. (1999) Heparin-induced thrombocytopenia: molecular pathogenesis Thromb Haemost 82, 448–56.
Rauova, L., Poncz, M., McKenzie, S.E., Reilly, M.P., Arepally, G., Weisel, J.W., Nagaswami, C., Cines, D.B., and Sachais, B.S. (2005) Ultralarge complexes of PF4 and heparin are central to the pathogenesis of heparin-induced thrombocytopenia Blood 105, 131–8.
Visentin, G.P., Ford, S.E., Scott, P.J., and Aster, R.H. (1994) Antibodies from patients with heparin-induced thrombocytopenia/thrombosis are specific for platelet factor 4 complexed with heparin or bound to endothelial cells J Clin Invest 93, 81–8.
Newman, P.M., and Chong, W.J. (1999) Further characterization of antibody and antigen in heparin-induced thrombocytopenia Br J Haematol 107, 303–9.
Amiral, J., Marfaing-Koka, M., Wolf, M., Alessi, M.C., Tardy, B., Boyer-Neumann, C., Vissac, A.M., Fressinaud, E., Poncz, M., and Meyer, D. (1996) Presence of autoantibodies to interleukin-8 or neutrophil-activating peptide-2 in patients with heparin-associated thrombocytopenia Blood 88, 410–6.
Regnault, V., deMaistre, E., Carteaux, J., Gruel, Y., and Nguyen, P. (2003) Platelet activation induced by human antibodies to interleukin-8 Blood 101, 1419–21.
Walenga, J.M., Prechel, M.M., Jeske, W.P., and Bakhos, M. (2005) Unfractionated heparin compared with low-molecular-weight heparin as related to heparin-induced thrombocytopenia Curr Opin Pulm Med 11, 385–91.
Jeske, W.P., Walenga, J.M., Szatkowski, E., Ero, M., Herbert, J.M., Haas, S., and Bakhos, M. (1997) Effect of glycoprotein IIb/IIIa antagonists on the HIT serum induced activation of platelets Thromb Res 88, 271–81.
Warkentin, T.E., Hayward, C.P., Boshkov, L.K., Santos, A.V., Sheppard, J.A., Bode, A.P., and Kelton. J.G. (1994) Sera from patients with heparin-induced thrombocytopenia generate platelet-derived microparticles with procoagulant activity: an explanation for the thrombotic complications of heparin-induced thrombocytopenia Blood 84, 3691–9.
Walenga, J.M., Jeske, W.P., Prechel, M.M., and Bakhos, M. (2004) Newer insights on the mechanism of heparin-induced thrombocytopenia Semin Thromb Hemost 30(Suppl 1), 57–67.
Jeske, W.P., Vasaiwala, S., Schlenker, R., Wallis, E., and Walenga, J.M. (2000) Leukocyte activation in heparin-induced thrombocytopenia Blood 96, 29b.
Pouplard, C., Iochmann, S., Renard, B., Herault, P., Colombat, P., Amiral, J., and Gruel, Y. (2001) Induction of monocyte tissue factor expression by antibodies to heparin-platelet factor 4 complexes developed in heparin-induced thrombocytopenia Blood 97, 3300–2.
Herbert, J.M., Savi, P., Jeske, W.P., and Walenga, J.M. (1998) Effect of SR121566A, a potent GP IIb-IIIa antagonist, on the HIT serum/heparin-induced platelet mediated activation of human endothelial cells Thromb Haemost 80, 326–31.
Walenga, J.M., Michal, K., Hoppensteadt, D., Wood, J.J., Bick, R.L., and Robinson, J.A. (1999) Vascular damage correlates between heparin-induced thrombocytopenia and the antiphospholipid syndrome Clin Appl Thromb Hemost 5(Suppl 1), S76–S84.
Fareed, J., Walenga, J.M., Hoppensteadt, D.A., Jeske, W.P., Lietz, H.W., Ahmad, S., Callas, D., Messmore, H.L., and Haas, S. (1999) Selectins in the HIT syndrome: pathophysiologic role and therapeutic modulation Semin Thromb Hemost 25(Suppl 1), 37–42.
Blank, M., Shoenfeld, Y., Tavor, S., Praprotnik, S., Boffa, M.C., Weksler, B., Walenga, J.M., Amiral, J., and Eldor, A. (2002) Anti-platelet factor 4/heparin antibodies from patients with heparin-induced thrombocytopenia provoke direct activation of microvascular endothelial cells Int Immunol 14, 121–9.
Matsuo, T., Tomaru, T., Kario, K., and Hirokawa, T. (2005) Incidence of heparin-PF4 complex antibody formation and heparin-induced thrombocytopenia in acute coronary syndrome Thromb Res 115, 475–81.
Opatrny, L., and Warner, M.N. (2004) Risk of thrombosis in patients with malignancy and heparin-induced thrombocytopenia Am J Hematol 76, 240–4.
Reininger, C.B., Greinacher, A., Graf, J., Lassila, R., Steckmeier, B., and Schwieberer, L. (1996) Platelets of patients with peripheral arterial disease are hypersensitive to heparin Thromb Res 81, 641–9.
Warkentin, T.E., Sheppard, J.A., Horsewood, P., Simpson, P.J., and Moore, J.C. (2000) Impact of the patient population on the risk for heparin-induced thrombocytopenia Blood 96, 1703–8.
Shuster, T.A., Silliman, W.R., Coats, R.D., Mureebe, L., and Silver, D. (2003) Heparin-induced thrombocytopenia: twenty-nine years later J Vasc Surg 38, 1316–22.
Warkentin, T.E., and Greinacher, A. (2004) Heparin-induced thrombocytopenia: recognition, treatment, and prevention Chest 126, 311S–37S.
Warkentin, T.E., and Crowther, M.A. (2007) When is HIT really HIT? Ann Thorac Surg 83, 21–3.
Lo, G.K., Juhl, D., Warkentin, T.E., Sigouin, C.S., Eichler, P., and Greinacher, A. (2006) Evaluation of pretest clinical score (4 T’s) for the diagnosis of heparin-induced thrombocytopenia in two clinical settings J Thromb Haemost 4, 759–65.
Pouplard, C., Amiral, J., Borg, J.Y., Laporte-Simitsidis, S., Delahousse, B., and Gruel, Y. (1999) Decision analysis for use of platelet aggregation test, carbon 14-serotonin release assay, and heparin-platelet factor 4 enzyme-linked immunosorbent assay for diagnosis of heparin-induced thrombocytopenia Am J Clin Pathol 111, 700–6.
Arepally, G.M., and Ortel, T.L. (2006) Clinical practice. Heparin-induced thrombocytopenia N Engl J Med 355, 809–17.
Parker, R.I. (2007) Measurement of heparin-dependent platelet antibodies in the diagnosis of heparin-induced thrombocytopenia: fact or fiction? Crit Care Med 35, 1784–5.
Lillo-Le Louet, A., Boutouyrie, P., Alhenc-Gelas, M., Le Beller, C., Gautier, I., Aiach, M., and Lasne, D. (2004) Diagnostic score for heparin induced thrombocytopenia after cardiopulmonary bypass J Thromb Haemost 2, 1882–8.
Chan, M., Malynn, E., Shaz, B., and Uhl, L. (2008) Utility of consecutive repeat HIT ELISA testing for heparin-induced thrombocytopenia Am J Hematol 83, 212–7.
Izban, K.F., Lietz, J.W., Hoppensteadt, D.A., Jeske, W.P., Fareed, J., Bakhos, M., and Walenga, J.M. (1999) Comparison of two PF4/Heparin ELISA assays for the laboratory diagnosis of heparin-induced thrombocytopenia Semin Thromb Hemost (Suppl 1) 25, 51–6.
Warkentin, T.E., and Greinacher, A. (2007) Laboratory testing for heparin-induced thrombocytopenia In: Warkentin, T.E., and Greinacher, A., eds. Heparin-Induced Thrombocytopenia, 4th edition. New York: Informa Healthcare; 2007:227–60.
Martin-Toutain, I., Piette, J.C., Diemert, M.C., Faucher, C., Jobic, L., and Ankri, A. (2007) High prevalence of antibodies to platelet factor 4 heparin in patients with antiphospholipid antibodies in absence of heparin-induced thrombocytopenia Lupus 16, 79–83.
Warkentin, T.E., Sheppard, J.A., Moore, J.C., Moore, K.M., Sigouin, C.S., and Kelton, J.G. (2005) Laboratory testing for the antibodies that cause heparin-induced thrombocytopenia: how much class to we need? J Lab Clin Med 146, 341–6.
Juhl, D., Eichler, P., Lubenow, N., Strobel, U., Wessel, A., and Greinacher, A. (2006) Incidence and clinical significance of anti-PF4/heparin antibodies of the IgG, IgM, and IgA class in 755 consecutive patients samples referred for diagnostic testing for heparin-induced thrombocytopenia Eur J Haematol 76, 420–6.
ISTH Platelet Immunology, Scientific Subcommittee. Chairs: Warkentin T, Chong B, Greinacher A, Gruel Y, Kiefel V, Kroll H. July 6, 2007, Palexpo, Geneva, Switzerland. Available at http://www.isth2007.com, Accessed on Dec. 6, 2007.
Alberio, L., Kimmerle, S., Baumann, A., Taleghani, B.M., Biasiutti, F.D., and Lammle, B. (2003) Rapid determination of anti-heparin/platelet factor 4 antibody titers in the diagnosis of heparin-induced thrombocytopenia Am J Med 114, 528–36.
Francis, J.L. (2003) A critical evaluation of assays for detecting antibodies to the heparin-PF4 complex Semin Thromb Hemost 30, 359–68.
Francis, J.L., Drexler, A., Duncan, M.K., Desai, H., Amaya, M., Robson, T., Meyer, T.V., Reyes, E., Rathmann, K., and Amirkhosravi, A. (2006) Prospective evaluation of laboratory tests for the diagnosis of heparin-induced thrombocytopenia Blood 108, 312a–3a.
Low, J., Austin, S., Bryant, A., and Joseph, J. (2007) Combining 4T’s pre-test clinical score and ID-PAGIA heparin/PF4 test to exclude heparin induced thrombocytopenia (HIT) J Thromb Haemost (Suppl 2) 5, P-W-332.
Walenga, J.M., Jeske, W.P., Fasanella, A.R., Wood, J.J., and Bakhos, M. (1999) Laboratory tests for the diagnosis of heparin-induced thrombocytopenia Semin Thromb Hemost (Suppl 1) 25, 43–9.
Chong, B.H., Burgess, J., and Ismail, F. (1993) The clinical usefulness of the platelet aggregation test for the diagnosis of heparin-induced thrombocytopenia Thromb Haemost 69, 344–50.
Warkentin, T.E., Hayward, C.P.M., Smith, C.A., Kelly, P.M., and Kelton, J.G. (1992) Determinants of donor platelet variability when testing for heparin-induced thrombocytopenia J Lab Clin Med 120, 371–9.
Eichler, P., Budde, U., Haas, S., Kroll, H., Loreth, R.M., Meyer, O., Pachmann, U., Potzsch, B., Schabel, A., Albrecht, D., and Greinacher, A. (1999) First workshop for detection of heparin-induced antibodies: validation of the heparin-induced platelet-activation test (HIPA) in comparison with a PF4/heparin ELISA Thromb Haemost 81, 625–9.
Greinacher, A., Michels, I., Kiefel, V., and Mueller-Eckhardt, C. (1991) A rapid and sensitive test for diagnosing heparin-induced thrombocytopenia Thromb Haemost 66, 734–6.
Tomer, A. (1997) A sensitive and specific functional flow cytometric assay for the diagnosis of heparin-induced thrombocytopenia Br J Haematol 98, 648–56.
Tomer, A., Masalunga, C., and Abshire, T.C. (1999) Determination of heparin-induced thrombocytopenia: a rapid flow cytometric assay for direct demonstration of antibody-mediated platelet activation Am J Hematol 61, 53–61.
Stewart, M.W., Etches, W.S., Boshkov, L.K., and Gordon, P.A. (1995) Heparin-induced thrombocytopenia: an improved method of detection based on lumi-aggregomaetry Br J Haematol 91, 173–7.
Pouplard, C., Gueret, P., Fouassier, M., Ternisien, C., Trossaert, M., and Regina, S. (2007) Prospective evaluation of the ‘4Ts’ score and particle gel immunoassay specific to heparin/PF4 for the diagnosis of heparin-induced thrombocytopenia J Thromb Haemost 5, 1373–9.
Warkentin, T.E. (2002) Platelet count monitoring and laboratory testing for heparin-induced thrombocytopenia Arch Path Lab Med 126, 1415–23.
Zwicker, J.I., Uhl, L., Huang, W.-Y., Shaz, B.H., and Bauer, K.A. (2004) Thrombosis and ELISA optical density values in hospitalized patients with heparin-induced thrombocytopenia J Thromb Haemost 2, 2133–7.
Altunas, F., Matevosyan, K., Burner, J., Shen, Y.M., and Sarode, R. (2008) Higher optical density of an antigen assay predicts thrombosis in patients with heparin-induced thrombocytopenia Eur J Haematol 80, 429–35.
Refaai, M.A., Laposata, M., and VanCott, E.M. (2003) Clinical significance of a borderline titer in a negative ELISA test for heparin-induced thrombocytopenia Am J Clin Pathol 119, 61–5.
Smythe, M.A., Koerber, J.M., and Mattson, J.C. (2005) An evaluation of heparin platelet factor 4 antibody testing J Thromb Haemost (Suppl 1) 3, P1516.
Stribling, W.K., Slaughter, T.F., Houle, T.T., and Sane, D.C. (2007) Beyond the platelet count: heparin antibodies as independent risk predictors Am Heart J 153, 900–6.
Mattioli, A.V., Bonetti, L., Sternieri, S., and Mattioli, G. (2000) Heparin-induced thrombocytopenia in patients treated with unfractionated heparin: prevalence of thrombosis in a 1 year follow-up Ital Heart J 1, 39–42.
Williams, R.T., Damaraju, L.V., Mascelli, M.A., Barnathan, E.S., Califf, R.M., Simoons, M.L., Deliargyris, E.N., and Sane, D.C. (2003) Anti-platelet factor 4/heparin antibodies: an independent predictor of 30 day myocardial infarction after acute coronary syndromes Circulation 107, 2307–12.
Bennett-Guerrero, E., Slaughter, T.F., White, W.D., Welsby, I.J., Greenberg, C.S., El-Moalem, H., and Ortel, T.L. (2005) Preoperative anti-PF4/heparin antibody level predicts adverse outcome after cardiac surgery J Thorac Cardiovasc Surg 130, 1567–72.
Pena de la Vega, L., Miller, R.S., Benda, M.M., Grill, D.E., Johnson, M.G., McCarthy, J.T., and McBane, R. (2005) Association of heparin-dependent antibodies and adverse outcomes in hemodialysis patients: a population-based study Mayo Clin Proc 80, 995–1000.
Lindhoff-Last, E., Eicher, P., Stein, M., Plagemann, J., Gerdsen, F., Wagner, R., Ehrly, A.M., and Bauersachs, R. (2000) A prospective study on the incidence and clinical relevance of heparin-induced antibodies in patients after vascular surgery Thromb Res 97, 387–93.
Warkentin, T.E., Levine, M.N., Hirsch, J., Horsewood, P., Roberts, R.S., Gent, M., and Kelton, J.G. (1995) Heparin-induced thrombocytopenia in patients treated with low-molecular-weight heparin or unfractionated heparin N Engl J Med 332, 1330–5.
Carrier, M., Rodger, M.A., Fergusson, D., Doucette, S., Kovacs, M.J., Moore, J., Kelton, J.G., and Knoll, G.A. (2008) Increased mortality in hemodialysis patients having specific antibodies to the platelet factor 4-heparin complex Kidney Internat 73, 213–9.
Wallis, D.E., Workman, D.L., Lewis, B.F., Pifarré, R., and Moran, J.F. (1999) Failure of early heparin cessation as a treatment for heparin-induced thrombocytopenia Am J Med 106, 629–35.
Messmore, H.L., Jeske, W.P., Wehrmacher, W.H., and Walenga, J.M. (2003) Benefit-risk assessment of treatments for heparin-induced thrombocytopenia Drug Safety 26, 625–41.
Lewis, B.E., Wallis, D.E., Berkowitz, S.D., Matthai, W.H., Fareed, J., Walenga, J.M., Bartholomew, J., Sham, R., Lerner, R.G., Zeigler, Z.R., Rustagi, P.K., Jang, I.K., Rifkin, S.D., Moran, J., Hursting, M.J., Kelton, J.G., and for the ARG-911 Study Investigators (2001) Argatroban anticoagulant therapy in patients with heparin-induced thrombocytopenia Circulation 103, 1838–43.
Lewis, B.E., Wallis, D.E., Leya, F., Hursting, M.J., Kelton, J.G., and for the Argatroban-915 Investigators (2003) Argatroban anticoagulation in patients with heparin-induced thrombocytopenia Arch Intern Med 163, 1849–56.
Greinacher, A., Völpel, H., Janssens, U., Hach-Wunderle, V., Kemkes-Matthes, B., Eichler, P., Mueller-Velten, H.G., Potzsch, B., and for the HIT Investigators Group (1999) Recombinant hirudin (lepirudin) provides safe and effective anticoagulation in patients with heparin-induced thrombocytopenia: a prospective study Circulation 99, 73–80.
Greinacher, A., Janssens, U., Berg, G., Bock, M., Kwasny, H., Kemkes-Matthes, B., Eichler, P., Volpel, H., Potzsch, B., Luz, M., and for the HAT Investigators (1999) Lepirudin (recombinant hirudin) for parenteral anticoagulation in patients with heparin-induced thrombocytopenia Circulation 100, 587–93.
Walenga, J.M., Fasanella, A.R., Iqbal, O., Hoppensteadt, D.A., Ahmad, S., Wallis, D.E., and Bakhos, M. (1999) Coagulation laboratory testing in patients treated with argatroban Semin Thromb Hemost 25(Suppl 1), 61–6.
Walenga, J.M., Drenth, A.F., Mayuga, M., Hoppensteadt, D.A., Prechel, M.M., Harder, S., Watanabe, H., Osakabe, M., and Breddin, H.K. (2008) Transition from argatroban to oral anticoagulation with phenprocoumon or acenocoumarol: effect on coagulation factor testing Clin Appl Thromb Hemost 14, 325–31.
Hirsh, J., Heddle, N., and Kelton, J.G. (2004) Treatment of heparin-induced thrombocytopenia Arch Intern Med 164, 361–9.
Warkentin, T.E. (2003) Management of heparin-induced thrombocytopenia: a critical comparison of lepirudin and argatroban Thromb Res 110, 73–82.
LeMonte, M.P., Brown, P.M., and Hursting, M.J. (2005) Alternative parenteral anticoagulation with argatroban, a direct thrombin inhibitor Expert Rev Cardiovasc Ther 3, 31–41.
Lewis, B.E., Walenga, J.M., and Hursting, M.J. (2002) Argatroban anticoagulation in patients with heparin-induced thrombocytopenia Cardiovasc Rev Rep 23, 445–57.
Swan, S.K., and Hursting MJ. (2000) The pharmacokinetics and pharmacodynamics of argatroban: effects of age, gender, and hepatic or renal dysfunction Pharmacotherapy 20, 318–29.
Swan, S.K., St. Peter, J.V., Lambrecht, L.J., and Hursting, M.J. (2000) Comparison of anticoagulant effects and safety of argatroban and heparin in healthy subjects Pharmacotherapy 20, 756–70.
Matthai, W.H., Jr., Hursting, M.J., Lewis, B.E., and Kelton, J.G. (2005) Argatroban anticoagulation in patients with a history of heparin-induced thrombocytopenia Thromb Res 116, 121–6.
Walenga, J.M., Ahmad, S., Hoppensteadt, D., Iqbal, O., Hursting, M.J., and Lewis, B.E. (2002) Argatroban therapy does not generate antibodies that alter its anticoagulant activity in patients with heparin-induced thrombocytopenia Thromb Res 105, 401–5.
Walenga, J.M., Fareed, D., Schultz, C., Neville, B., and Hoppensteadt, D. (2004) Argatroban, not lepirudin or bivalirudin, treatment results in the generation of nitric oxide during parenteral administration Blood 104, 512a.
Lewis, B.E., Matthai, W.H., Cohen, M., Moses, J., Hursting, J., and Leya F. (2002) Argatroban anticoagulation during percutaneous coronary intervention in patients with heparin-induced thrombocytopenia Cathet Cardiovasc Intervent 57, 177–84.
Cornell, T., Wyrick, P., Fleming, G., Pasko, D., Han, Y., Custer, J., Haft, J., and Annich, G. (2007) A case series describing the use of argatroban in patients on extracorporeal circulation ASAIO J 53, 460–3.
Potter, K.E., Raj, A., and Sullivan, J.E. (2007) Argatroban for anticoagulation in pediatric patients with heparin-induced thrombocytopenia requiring extracorporeal life support J Ped Hematol Oncol 29, 265–8.
Jang, I., and Hurstings, M.J. (2005) When heparins promote thrombosis: review of heparin-induced thrombocytopenia Circulation 111, 2671–83.
Cetta, F., Graham, L.C., Wrona, L.L., Arruda, M.J., and Walenga, J.M. (2004) Argatroban use during pediatric interventional cardiac catheterization Cathet Cardiovasc Intervent 61, 147–9.
Jang, I.K., Lewis, B.E., Matthai, W.H., and Kleiman, N.S. (2004) Argatroban anticoagulation in conjunction with glycoprotein IIb/IIIa inhibition in patients undergoing percutaneous coronary intervention: an open-label, nonrandomized pilot study J Thromb Thrombol 18, 31–7.
LaMonte, M.P., Brown, P.M., and Hursting, M.J. (2004) Stroke in patients with heparin-induced thrombocytopenia and the effect of argatroban therapy Crit Care Med 32, 976–80.
Eichler, P., Friesen, H.J., Lubenow, N., Jaeger, B., and Greinacher, A. (2000) Anti-hirudin antibodies in patients with heparin-induced thrombocytopenia treated with lepirudin: incidence, effects on aPTT, and clinical relevance Blood 96, 2373–8.
Greinacher, A., Eichler, P., Albrecht, D., Strobel, U., Potzsch, B., and Eriksson, B.I. (2003) Anti-hirudin antibodies following low-dose subcutaneous treatment with desirudin for thrombosis prophylaxis after hip-replacement surgery: incidence and clinical relevance Blood 101, 2617–9.
Fischer, K.G., Liebe, V., Hudek, R., Piazolo, L., Haase, K.K., Borggrefe, M., and Huhle, G. (2003) Anti-hirudin antibodies alter pharmacokinetics and pharmacodynamics of recombinant hirudin Thromb Haemost 89, 973–82.
Greinacher, A., Lubenow, N., and Eichler, P. (2003) Anaphylactic and anaphylactoid reactions associated with lepirudin in patients with heparin-induced thrombocytopenia (HIT) Circulation 108, 2062–5.
Cochran, K., DeMartini, T.J., Lewis, B.E., O’Brien, J., Steen, L.H., Grassman, E.D., and Leya, F. (2003) Use of lepirudin during percutaneous vascular interventions in patients with heparin-induced thrombocytopenia J Invas Cardiol 15, 622–3.
Mahaffey, K.W., Lewis, B.E., Wildermann, N.M., Berkowitz, S.D., Oliverio, R.M., Turco, M.A., Shalev, Y., Lee, P.V., Traverse, J.H., Rodriguez, A.R., Ohman, E.M., Harrington, R.A., Califf, R., and for the ATBAT Investigators (2003) The anticoagulant therapy with bivalirudin to assist in the performance of PCI in patients with heparin-induced thrombocytopenia (ATBAT) study J Invas Cardiol 15, 611–6.
Merry, A.F., Raudkivi, P.J., Middleton, N.G., McDougall, J.M., Nand, P., Mills, B.P., Webber, B.J., Frampton, C.M., and White, H.D. (2004) Bivalirudin versus heparin and protamine in off-pump coronary artery bypass surgery Ann Thorac Surg 77, 925–31.
Koster, A., Spiess, B., Chew, D.P., Krabatsch, T., Tambeur, L., DeAnda, A., Hetzer, R., Kuppe, H., Smedira, N.G., and Lincoff, A.M. (2004) Effectiveness of bivalirudin as a replacement for heparin during cardiopulmonary bypass in patients undergoing coronary artery bypass grafting Am J Cardiol 93, 356–9.
Magnani, H.N., and Gallus, A. (2006) Heparin-induced thrombocytopenia (HIT). A report of 1,478 clinical outcomes of patients treated with danaparoid (Orgaran) from 1982 to mid-2004 Thromb Haemost 95, 967–81.
Lindhoff-Last, E., Kreutzenbeck, H-J., and Magnani H.N. (2005) Treatment of 51 pregnancies with danaparoid because of heparin intolerance Thromb Haemost 93, 63–9.
Chong, B.H., Gallus, A.S., Cade, J.F., Magnani, H., Manoharan, A., Oldmeadow, M., and for the Australian HIT Study Group (2001) Prospective randomized open-label comparison of danaparoid with dextran 70 in the treatment of heparin-induced thrombocytopenia with thrombosis Thromb Haemost 86, 1170–5.
Farner, B., Eichler, P., Kroll, H., and Greinacher, A. (2001) A comparison of danaparoid and lepirudin in heparin-induced thrombocytopenia Thromb Haemost 85, 950–7.
Walenga, J.M., Koza, M.J., Lewis, B.E., and Pifarré, R. (1996) Relative heparin-induced thrombocytopenic potential of low molecular weight heparins and new antithrombotic agents Clin Appl Thromb Hemost 2(Suppl 1), S21–7.
Elalamy, I., Lecrubier, C., Horellou, M.H., Conard, J., and Samama, M.M. (2000) Heparin-induced thrombocytopenia: laboratory management Ann Med 32(Suppl 1), 60–7.
Parody, R., Oliver, A., Souto, J.C., and Fontcuberta, J. (2003) Fondaparinux (Arixtra) as an alternative anti-thrombotic prophylaxis when there is hypersensitivity to low molecular weight and unfractionated heparins Haematologica 88, ECR32.
D’Amico, E.A., Villaca, P.R., Gualandro, S.F., Bassitt, R.P., and Chamone, D.A. (2003) Successful use of Arixtra in a patient with paroxysmal nocturnal hemoglobinuria, Budd-Chiari syndrome and heparin-induced thrombocytopenia J Thromb Haemost 1, 2452–3.
Bradner, J., Hallisey, R.K., and Kuter, D.J. (2004) Fondaparinux in the treatment of heparin-induced thrombocytopenia Blood 104, Abstract 1775.
Lobo, B., Finch, C., Howard, A., and Minhas S. (2008) Fondaparinux for the treatment of patients with acute heparin-induced thrombocytopenia Thromb Haemost 99, 208–14.
Warkentin TE, Maurer, B.T., and Aster, R.H. (2007) Heparin-induced thrombocytopenia associated with fondaparinux N Engl J Med 356, 2653–5.
Rota, E., Bazzan, M., and Fantino, G. (2008) Fondaparinux-related thrombocytopenia in a previous low-molecular-weight heparin (LMWH)-induced heparin-induced thrombocytopenia (HIT) Thromb Haemost 99, 779–81.
Warkentin, T.E., Cook, R.J., Marder, V.J., Sheppard, J.A., Moore, J.C., Eriksson, B.I., Greinacher, A., and Kelton, J.G. (2005) Anti-platelet factor 4/heparin antibodies in orthopedic surgery patients receiving antithrombotic prophylaxis with fondaparinux or enoxaparin Blood 106, 3791–6.
Eriksson, B.I., Borris, L.C., Dahl, O.E., Haas, S., Huisman, M.V., Kakkar, A.K., Misselwitz, F., Muehlhofer, E., and Kalebo, P. (2007) Dose-escalation study of rivaroxaban (BAY 59-7939), an oral, direct factor Xa inhibitor, for the prevention of venous thromboembolism in patients undergoing total hip replacement Thromb Res 120, 685–93.
Agnelli, G., Gallus, A., Goldhaber, S.Z., Haas, S., Huisman, M.V., Hull, R.D., Kakkar, A.K., Misselwitz, F., Schellong, S., and for the ODIXa-DVT Study Investigators. (2007) Treatment of proximal deep-vein thrombosis with the oral direct factor Xa inhibitor rivaroxaban (BAY 59-7939): the ODIXa-DVT (Oral direct factor Xa inhibitor BAY 59-7939 in patients with acute symptomatic deep-vein thrombosis) study Circulation 116, 180–7.
Erikkson, B.I., Borris, L.C., Dahl, O.E., Haas, S., Huisman, M.V., Kakkar, A.K., Muehlhofer, E., Dierig, C., Misselwitz, F., Kalebo, P., and for the ODIXa-HIP Study Investigators. (2006) A once-daily, oral direct factor Xa inhibitor, rivaroxaban (BAY 59-7939), for thromboprophylaxis after total hip replacement Circulation 114, 2374–81.
Lassen, M.R., Davidson, B.L., Gallus, A., Pineo, G., Ansell, J., and Deitchman, D. (2007) The efficacy and safety of apixban, an oral, direct factor Xa inhibitor, as thromboprophylaxis in patients following total knee replacement J Thromb Haemost 5, 2368–75.
Walenga, J.M., Jeske, W.P., Prechel, M., Hoppensteadt, D., Swank, J., Sheen, L., Misselwitz, F., Messmore, H., and Bakhos, M. (2007) Potential of the factor Xa inhibitor rivaroxaban for the anticoagulation management of patients with heparin-induced thrombocytopenia J Thromb Haemost 5(Suppl 2), P-M-648.
Wallis, D.E., Quintos, R., Wehrmacher, W., and Messmore, H.L. (1999) Safety of warfarin anticoagulation in patients with heparin-induced thrombocytopenia Chest 116, 1333–8.
Gosselin, R.C., Dager, W.E., King, J.H., Janatpour, K., Mahackian, K., Larkin, E.C., and Owings, J.T. (2004) Effect of direct thrombin inhibitors, bivalirudin, lepirudin, and argatroban, on prothrombin time and INR values Am J Clin Pathol 121, 593–9.
Sheth, S.B., DiCicco, R.A., Hursting, M.J., Montague, T., and Jorkasky, D.K. (2001) Interpreting the international normalized ratio (INR) in individuals receiving argatroban and warfarin Thromb Haemost 85, 435–40.
Harder, S., Graff, J., Klinkhardt, U., von Hentig, N., Walenga, J.M., Watanabe, H., Osakabe, M., and Breddin, H.K. (2004) Transition from argatroban to oral anticoagulation with phenprocoumon or acenocoumarol: effects on PT, aPTT, and ecarin clotting time Thromb Haemost 91, 1137–45.
Hursting, M.J., Lewis, B.E., and Macfarlane, D.E. (2005) Transitioning from argatroban to warfarin therapy in patients with heparin-induced thrombocytopenia Clin Appl Thromb Hemost 11, 279–87.
Pötzsch, B., and Klovekorn, W.P. (2000) Use of heparin during cardiopulmonary bypass in patients with a history of heparin-induced thrombocytopenia N Engl J Med 343, 515–6.
Walenga, J.M., Jeske, W.P., Wallis, D.E., Bakhos, M., Lewis, B.E., Leya, F., and Fareed, J. (1999) Clinical experience with combined treatment of thrombin inhibitors and GPIIb/IIIa inhibitors in patients with HIT Semin Thromb Hemost 25(Suppl 1), 77–81.
Walenga, J.M., Lewis, B.E., Jeske, W.P., Leya, F., Wallis, D.E., Bakhos, M., and Fareed, J. (1999) Combined thrombin and platelet inhibition treatment for HIT patients Hämostaseologie 19, 128–33.
Haas, S., Walenga, J.M., Jeske, W.P., and Fareed, J. (1999) Heparin-induced thrombocytopenia: the role of platelet activation and therapeutic implications Semin Thromb Hemost 25(Suppl 1), 67–75.
Fareed, J., Bick, R.L., Rao, G., Goldhaber, S.Z., Sasahara, A., Messmore, H.L., Hoppensteadt, D.A., and Nicolaides, A. (2008) The immunogenic potential of generic versions of low-molecular weight heparins may not be the same as the branded products Clin Appl Thromb Hemost 14, 5–7.
Houiste, C., Auguste, C., Macrez, C., Dereux, S., Derouet, A., and Anger, P. (2009) Quantitative PCR and disaccharide profiling to characterize the animal origin of low-molecular-weight heparins Clin Appl Thromb Hemost 15, 50–8.
Kishimoto, T.K., Viswanathan, K., Ganguly, T., Elankumaran, S., Smith, S., Pelzer, K., Lansing, J.C., Sriranganathan, N., Zhao, G., Galcheva-Gargova, Z., Al-Hakim, A., Bailey, G.S., Fraser, B., Roy, S., Rogers-Cotrone, T., Buhse, L., Whary, M., Fox, J., Nasr, M., Dal Pan, G.J., Shriver, Z., Langer, R.S., Venkataraman, G., Austen, K.F., Woodcock, J., and Sasisekharan, R. (2008) Contaminated heparin associated with adverse clinical events and activation of the contact system N Engl J Med 358, 2457–67.
Guerrini, M., Beccati, D., Shriver, Z., Naggi, A., Viswanathan, K., Bisio, A., Capila, I., Lansing, J.C., Guglieri, S., Fraser, B., Al-Hakim, A., Gunay, N.S., Zhang, Z., Robinson, L., Buhse, L., Nasr, M., Woodcock, J., Langer, R., Venkataraman, G., Linhardt, R.J., Casu, B., Torri, G., and Sasisekharan, R. (2008) Oversulfated chondroitin sulfate is a contaminant in heparin associated with adverse clinical events Nat Biotechnol 26, 669–75.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer Science+Business Media, LLC
About this protocol
Cite this protocol
Prechel, M., Jeske, W.P., Walenga, J.M. (2010). Laboratory Methods and Management of Patients with Heparin-Induced Thrombocytopenia. In: Mousa, S. (eds) Anticoagulants, Antiplatelets, and Thrombolytics. Methods in Molecular Biology, vol 663. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60761-803-4_4
Download citation
DOI: https://doi.org/10.1007/978-1-60761-803-4_4
Published:
Publisher Name: Humana Press, Totowa, NJ
Print ISBN: 978-1-60761-802-7
Online ISBN: 978-1-60761-803-4
eBook Packages: Springer Protocols