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• W4206573926 startingPage "322" @default.
• W4206573926 abstract "Heparin-induced thrombocytopenia (HIT) is a relatively common prothrombotic adverse effect of heparin both unfractionated and (less often) low-molecular-weight heparin caused by antibodies that recognize multimolecular complexes of (positively charged) platelet factor 4 (PF4) bound to (negatively charged) heparin. The antibodies strongly activate platelets through their Fc?RIIa receptors, producing a procoagulant platelet response that results in hypercoagulability and increased thrombotic risk. Certain tests for HIT antibodies, such as PF4-dependent immunoassays and platelet activation assays, are very sensitive; thus, a negative test result essentially rules out HIT (high negative predictive value). However, only approximately half of immunoassay-positive patients (and only 15% among critically ill patients) also have a positive platelet activation assay, and thus the possibility of ‘true’ HIT. Treatment of acute HIT emphasizes substitution of heparin with a nonheparin anticoagulant, such as indirect, antithrombin-dependent factor Xa inhibitors (e.g. danaparoid, fondaparinux) or direct thrombin inhibitors (e.g. argatroban, recombinant hirudin, bivalirudin), while vitamin K antagonists must be avoided." @default.
• W4206573926 created "2022-01-25" @default.
• W4206573926 creator A5075868354 @default.
• W4206573926 creator A5084098960 @default.
• W4206573926 date "2013-02-26" @default.
• W4206573926 modified "2023-09-23" @default.
• W4206573926 title "Heparin-Induced Thrombocytopenia" @default.
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• W4206573926 doi "https://doi.org/10.1002/9781118520093.ch30" @default.
• W4206573926 hasPublicationYear "2013" @default.
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