Article Synopsis
- The study analyzed data from 144 French patients with heparin-induced thrombocytopenia (HIT) to investigate clinical outcomes and compare with existing literature.
- Two-thirds of patients were hospitalized for surgery, primarily treated with unfractionated heparin, and the majority experienced venous thrombosis, particularly after cardiac procedures.
- Findings indicate a decreased mortality rate in this cohort compared to previous studies, potentially due to better diagnosis and treatment, and highlight a link between a specific genetic polymorphism and increased thrombosis risk in HIT patients.
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Article Abstract
Background: Heparin-induced thrombocytopenia (HIT) is a rare complication of heparin treatments, and only a few large patient cohorts have been reported. In this study, biological and clinical data from 144 French patients with HIT were analyzed in comparison with the literature.
Methods: The diagnosis of HIT was confirmed in all patients by an immunoassay combined with serotonin release assay. In the literature, only cohorts of at least 20 HIT patients published from 1992 were selected for a comparative analysis.
Results: Two-thirds of patients were hospitalized in surgery and most were treated with unfractionated heparin (83.2% vs. 16.8% with low molecular weight heparin only). Thrombotic events in 54 patients (39.7%) were mainly venous (41/54). However, arterial thrombosis was more frequent after cardiac surgery (13.2% vs. 2.4% in other surgeries, = 0.042) with a shorter recovery time (median = 3 vs. 5 days, < 0.001). The mortality rate was lower in our series than in the 22 selected published studies (median = 6.3% vs. 15.9%). Three genetic polymorphisms were also studied and homozygous subjects FcγRIIA RR were more frequent in patients with thrombosis (37.8 vs. 18.2% in those without thrombosis, = 0.03).
Conclusion: This study shows that the mortality rate due to HIT has recently decreased in France, possibly due to earlier diagnosis and improved medical care. It also confirms the strong association between polymorphism FcγRIIA H131R and thrombosis in HIT.
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