Differences in the clinical course of heparin induced thrombocytopenia before and after the availability of HIT IgG class testing

• Published in: Thrombosis research Vol. 134; no. 1; pp. 90 - 92
• Main Authors: Reagan, John L, Ingham, Randall R, Dalia, Samir, Butera, James N, Sweeney, Joseph D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Ltd 01.07.2014
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bleeding risk; Cohort Studies; Female; Hematology, Oncology and Palliative Medicine; Heparin - adverse effects; Heparin Induced Thrombocytopenia; Humans; IgG EIA; Immunoglobulin G - analysis; Male; Middle Aged; Overdiagnosis; Retrospective Studies; Thrombocytopenia - chemically induced; Thrombocytopenia - diagnosis; Young Adult; Bleeding risk; IgG EIA; Heparin Induced Thrombocytopenia; Overdiagnosis
• ISSN: 0049-3848; 1879-2472
• DOI: 10.1016/j.thromres.2014.04.030

Abstract Introduction To determine whether the HIT IgG class platelet factor 4 (PF4) enzyme immunoabsorbant assay (EIA) influenced the duration of parenteral direct thrombin inhibitor (pDTI) therapy or bleeding risk in patients started on pDTI for a presumed diagnosis of HIT. Materials/Methods 187 patients started on pDTI for presumed HIT were assessed in two time periods before (period 1, n = 88 patients) and after the introduction of an IgG-specific assay (period 2, n = 99 patients). Results Patients in period 2 were treated with pDTI therapy for a median of 5 days less (p < 0.0001) however the incidence of Grade III and IV bleeding episodes was not different. Bleeding was observed to occur early during the hospital course at a median of 2-3 days after initiation of the pDTI. The average pDTI drug acquisition cost was markedly decreased in period 2 when compared to period 1 (p < 0.0001). Conclusions Implementation of the IgG class HIT EIA resulted in a decrease in the number of days on a pDTI and a decrease in the average pDTI acquisition cost per patient without an observed change in serious bleeding events.