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Heparin induced thrombocytopenia.
H C Chua1, N Venketasubramanian, H Tjia
1Department of Neurology, National Neuroscience Institute, Tock Seng, Singapore.
Singapore Medical Journal
|August 22, 2001
Summary
Heparin-induced thrombocytopenia (HIT) is a common complication of heparin therapy, affecting 4% of patients in this study. Monitoring platelet counts is crucial to manage this reversible side effect and prevent serious complications.
Area of Science:
- Cardiology
- Hematology
- Neurology
Background:
- Heparin is a critical antithrombotic agent for ischemic cerebrovascular disease.
- A significant side effect of heparin is thrombocytopenia, which can cause severe bleeding or clotting.
- Heparin-induced thrombocytopenia (HIT) poses a risk of life-threatening complications.
Purpose of the Study:
- To prospectively determine the incidence of heparin-induced thrombocytopenia (HIT).
- To define diagnostic criteria for HIT.
- To evaluate the clinical outcomes associated with HIT.
Main Methods:
- A prospective study involving 50 adult patients receiving intravenous bovine heparin.
- Defined HIT as a platelet count < 150 x 10(3)/mm3 or a 30-50% drop from baseline.
- Monitored daily platelet counts throughout heparin therapy.
Main Results:
- Two patients (4%) developed HIT, with onset between 4-7 days of heparin treatment.
- Platelet counts normalized within 3-5 days after discontinuing heparin.
- No ischemic or hemorrhagic complications were observed in the affected patients.
Conclusions:
- HIT is a frequent complication of intravenous heparin therapy.
- Regular platelet count monitoring, starting on day 5, is recommended for patients on heparin.
- Concurrent warfarin therapy with heparin, followed by heparin discontinuation, is advised to manage HIT effectively.