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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 e4 (June 2006) DOI: /j.jtcvs Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions
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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 , e4DOI: ( /j.jtcvs ) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions
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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 , e4DOI: ( /j.jtcvs ) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions
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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 , e4DOI: ( /j.jtcvs ) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions
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Figure E1 Receiver operating characteristic (ROC) curve for multivariate regression model to predict thrombotic events. Area under curve ± (0.813; 0.956); P < Regression equation: z = − · b · b · 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 , e4DOI: ( /j.jtcvs ) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions
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