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Original Research: Pulmonary Vascular Disease |

Is the Incidence of Heparin-Induced Thrombocytopenia Affected by the Increased Use of Heparin for VTE Prophylaxis?Incidence of Heparin-Induced Thrombocytopenia

Amy Zhou, MD; Anne Winkler, MD; Amir Emamifar, PharmD; Bryce Gartland, MD; Alexander Duncan, MD; Ana Antun, MD; Martha Arellano, MD; G. Allen Tindol, MD; Jerrold H. Levy, MD; William A. Bornstein, MD; Ira R. Horowitz, MD; Hanna Jean Khoury, MD
Author and Funding Information

From the Department of Medicine (Drs Zhou, Gartland, and Bornstein); the Department of Pathology (Drs Winkler and Duncan); Emory University Hospital Department of Pharmacy (Dr Emamifar); the Department of Hematology and Medical Oncology and the Winship Cancer Institute of Emory University (Drs Antun, Arellano, Tindol, and Khoury); the Departments of Anesthesiology and Critical Care (Dr Levy); and the Division of Gynecologic Oncology and the Winship Cancer Institute (Dr Horowitz), Emory University School of Medicine, Atlanta, GA.

Correspondence to: Hanna Jean Khoury, MD, Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, 1365 Clifton Rd NE, Ste C1152, Atlanta, GA 30322; e-mail: hkhoury@emory.edu


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2012;142(5):1175-1178. doi:10.1378/chest.11-2926
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Background:  The increased exposure to heparin products for thromboprophylaxis against VTE in hospitalized patients raises concerns for an increase in the incidence of heparin-induced thrombocytopenia (HIT).

Methods:  We analyzed, among 90,875 patients exposed to heparin products between 2005 and 2009, the number of hematologic consultations for thrombocytopenia, requests for heparin-induced antibodies by enzyme-linked immunosorbent assay, and cases given a diagnosis of HIT by the hematology consult service.

Results:  We observed that despite a doubling in the number of patients receiving pharmacoprophylaxis with heparin, there was no significant increase in the number of consultations for thrombocytopenia, the number of requests for HIT tests, the number of positive HIT test results, or the number of HIT diagnoses. The number of cases of HIT was low and represented < 0.1% of patients exposed to heparin.

Conclusions:  We conclude that concerns about HIT should not be a limiting factor for the systematic implementation of heparin-based VTE prophylaxis.


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