Predictors for the Development of Elevated Anti-heparin/Platelet Factor 4 Antibody Titers in Patients Undergoing Cardiac Catheterization.
From: Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
The American journal of cardiology
- Publish Date: Aug 2006
- ISSN: 0002-9149
- Volume: 98
- Issue: 3
- Pages: 419-21
- Medium: Print
- Language: English
- Citation (JAMA): Yeh Robert W, Everett Brendan M, Foo Shi-Yin, et al. Predictors for the Development of Elevated Anti-heparin/Platelet Factor 4 Antibody Titers in Patients Undergoing Cardiac Catheterization.. Am. J. Cardiol. Aug 2006;98:419-21
Abstract
A substantial proportion of patients who undergo cardiac catheterization develop antibodies directed against the heparin/platelet factor 4 (PF4) complex after the procedure, which have been implicated in the pathogenesis of heparin-induced thrombocytopenia. This study attempted to identify factors that predicted the development of these antibodies in a prospective cohort study. Antiheparin/PF4 antibody titers were measured at baseline and again 5 +/- 2 days after cardiac catheterization by enzyme-linked immunosorbent assay. A total of 311 patients who underwent cardiac catheterization were included in the analysis. Of these, 25 (8.0%) developed positive antibody levels after catheterization. Patients who had positive antibody test results after catheterization had significantly greater baseline antiheparin/PF4 antibody titers compared with those whose titers remained low (optical density 0.227 vs 0.158, p < 0.001). In a logistic regression model, greater baseline antibody titers, a history of heparin exposure, and a lower platelet count at enrollment were the strongest predictors of conversion to positive antiheparin/PF4 antibody titers after cardiac catheterization. It is possible to identify patients at high risk for developing elevated titers of antiheparin/PF4 antibodies on the basis of their baseline clinical characteristics.
Mesh Headings (Keywords): Antibodies, Anticoagulants, Enzyme-Linked Immunosorbent Assay, Female, Follow-Up Studies, Heart Catheterization, Heparin, Humans, Male, Middle Aged, Platelet Factor 4, Prognosis, Prospective Studies, Risk Factors, Thrombocytopenia
Check for Full Text / PubMed Unique Identifier (PMID): 16860036
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