Heparin-induced thrombocytopenia in patients receiving mechanical circulatory support  Soren Schenk, MD, Aly El-Banayosy, MD, Wolfgang Prohaska, MD, Latif Arusoglu, MD, Michiel Morshuis, MD, Wilhelm Koester- Eiserfunke, PhD, Lukasz Kizner, MD, Edward Murray, MD, Petra Eichler, PhD, Reiner Koerfer, MD, Andreas Greinacher, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 131, Issue 6, Pages 1373-1381.e4 (June 2006) DOI: 10.1016/j.jtcvs.2006.01.048 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Sequence of anti-PF4/heparin antibody testing. MCS, mechanical circulatory support; EIA GTI, polyspecific anti-PF4/heparin antibody enzyme immunoassay; EIA HGW, monospecific anti-PF4/heparin antibody enzyme immunoassay; HIPA, heparin-induced platelet activation assay; HIT, heparin-induced thrombocytopenia; POD, postoperative day; Ig, immunoglobulin. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1373-1381.e4DOI: (10.1016/j.jtcvs.2006.01.048) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, Platelet counts during mechanical support. B, Relative platelet counts (percent change from baseline) during mechanical support. Numbers in parentheses indicate patients for whom data are available. Vertical bars indicate 1 SD. Solid line (—), Heparin-induced platelet activation assay positive or indeterminate with IgG titers of OD > 1.0; solid line with squares (–■–), heparin-induced thrombocytopenia negative; solid line with triangles (–▴–), heparin-induced thrombocytopenia platelet activation assay negative and IgG, IgA, or IgM antibodies. *P < .05. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1373-1381.e4DOI: (10.1016/j.jtcvs.2006.01.048) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Freedom from thromboembolic events during mechanical support. HIPA+&id/IgG+, Heparin-induced platelet activation assay positive or indeterminate with IgG titers of OD > 1.0; HIT−, heparin-induced thrombocytopenia negative; HIPA−/ IgG,A,M+, heparin-induced thrombocytopenia platelet activation assay negative and IgG, IgA, or IgM antibodies. The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1373-1381.e4DOI: (10.1016/j.jtcvs.2006.01.048) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Receiver operating characteristic (ROC) curve for multivariate regression model to predict thrombotic events. Area under curve 0.885 ± 0.037 (0.813; 0.956); P < .001. Regression equation: z = −9.017 + 2.454 · b1 + 4.292 · b2 + 0.009 · b3, where b1 is titer of anti-PF4/heparin antibodies by polyspecific enzyme immunoassay (OD), b2 is gender (1, female; 0, male), and b3 is fibrinogen (mg/dL). The Journal of Thoracic and Cardiovascular Surgery 2006 131, 1373-1381.e4DOI: (10.1016/j.jtcvs.2006.01.048) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions