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Lori-Ann Linkins, MD; Antonio L. Dans, MD; COL Lisa K. Moores, MC, USA, MD, FCCP; Bruce L. Davidson, MD, MPH, FCCP; Sam Schulman, MD, PhD; Mark Crowther, MD
Author and Funding Information

From the Department of Medicine (Drs Linkins, Schulman, and Crowther), McMaster University; University of the Philippines Manila (Dr Dans); The Uniformed Services (COL Moores), University of Health Sciences; and University of Washington School of Medicine (Dr Davidson).

Correspondence to: Lori-Ann Linkins, MD, Department of Medicine, McMaster University, Juravinski Hospital, Room A3-74, 1280 Main St W, Hamilton, ON, L8S 4K1, Canada; e-mail: linkinla@mcmaster.ca


Financial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

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


Chest. 2013;143(4):1191. doi:10.1378/chest.13-0035
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To the Editor:

Dr Junqueira has brought to our attention that some of the studies referenced in Table 2 (regarding the incidence of heparin-induced thrombocytopenia [HIT]) in the “Treatment and Prevention of Heparin-Induced Thrombocytopenia” chapter in the most recent edition of the antithrombotic therapy and prevention of thrombosis clinical practice guidelines1 are of poor methodologic quality. Many of the studies in the HIT literature, including those that reported the incidence of HIT, are of similar poor quality. In preparing this topic, we did not conduct a formal meta-analysis of HIT incidence studies primarily because evaluating the incidence of HIT was not one of our objectives. The references provided in the table were only intended to be examples of the incidence in various patient populations and heparin exposure groups. It is noteworthy, however, that had we conducted a formal meta-analysis as Dr Junqueira did in a recently published review,2 the result would not have been significantly different from that we provided in the table.

References

Linkins LA, Dans AL, Moores LK, et al; American College of Chest Physicians. Treatment and prevention of heparin-induced thrombocytopenia: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(suppl 2):e495S-e530S. [CrossRef] [PubMed]
 
Junqueira DR, Perini E, Penholati RR, Carvalho MG. Unfractionated heparin versus low molecular weight heparin for avoiding heparin-induced thrombocytopenia in postoperative patients. Cochrane Database Syst Rev. 2012;9:CD007557. [PubMed]
 

Figures

Tables

References

Linkins LA, Dans AL, Moores LK, et al; American College of Chest Physicians. Treatment and prevention of heparin-induced thrombocytopenia: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2012;141(suppl 2):e495S-e530S. [CrossRef] [PubMed]
 
Junqueira DR, Perini E, Penholati RR, Carvalho MG. Unfractionated heparin versus low molecular weight heparin for avoiding heparin-induced thrombocytopenia in postoperative patients. Cochrane Database Syst Rev. 2012;9:CD007557. [PubMed]
 
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