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Heparin-platelet factor 4 antibodies in patients presenting to the ED with thrombosis.
Francis, John L; Drexler, Alane; Duncan, Mary Kathryn; Walker, Jamie M; Hursting, Marcie J; Levine, Robert L.
Afiliación
  • Francis JL; Florida Hospital Institute of Translational Research, Orlando, FL 32804, USA. john.francis@flhosp.org
Am J Emerg Med ; 25(3): 279-84, 2007 Mar.
Article en En | MEDLINE | ID: mdl-17349901
BACKGROUND: Patients with heparin-platelet factor 4 (PF4) antibodies, particularly platelet-activating ones, are at risk for heparin-induced thrombocytopenia if administered heparin. We determined the heparin-PF4 antibody prevalence in emergency department (ED) patients presenting with chest pain or symptoms of thrombosis. METHODS: Admission samples from 324 ED patients with chest pain or symptoms of thrombosis were tested for heparin-PF4 antibodies and, if positive, platelet-activating antibodies. RESULTS: Twenty-four (7.4%; 95% confidence interval, 4.8%-10.8%) patients had heparin-PF4 antibodies. Seropositivity occurred in 18 (9.2%) of 196 patients recently (< or =6 months) hospitalized vs 6 (4.7%) of 128 not recently hospitalized (P = .19), and in 16/231 (6.9%) patients with chest pain vs 8/93 (8.6%) with other thrombosis (P = .64). Of 22 seropositive patients retested, 8 (7 recently hospitalized) had platelet-activating antibodies. CONCLUSION: Heparin-PF4 antibody prevalence is 7.4% in ED patients with chest pain or thrombosis, with approximately 1 in 3 seropositive patients having platelet-activating antibodies. Alternative, nonheparin anticoagulation would be prudent in these at-risk patients.
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombocitopenia / Trombosis / Factor Plaquetario 4 / Heparina / Servicio de Urgencia en Hospital / Anticuerpos / Anticoagulantes Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Am J Emerg Med Año: 2007 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombocitopenia / Trombosis / Factor Plaquetario 4 / Heparina / Servicio de Urgencia en Hospital / Anticuerpos / Anticoagulantes Tipo de estudio: Observational_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Am J Emerg Med Año: 2007 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos