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Abstract
Background
The aims of this study were to find the incidence and clinical features of Heparin-induced thrombocytopenia (HIT) in acute coronary syndrome patients treated with unfractionated heparin.
Methods
The medical records of 554 patients treated with unfractionated heparin (UFH) for their coronary artery diseases at the Gachon Medical School Gil Heart Center during 2002～2003. were retrospectively reviewed. The gourp eligible group inclusion in this study was comprised of 338 patients with acute coronary syndrome
Results
The median duration of UFH administration was 6 days, ranging from 1 to 22 days. Among the eligible patients, 40 (11.8%) received UFH for ＞96 hours, and developed thrombocytopenia, which involved a platelet count decrease to less than 100,000 per cubic millimeter or a 50% or greater decrease in the platelet count.
Conclusion
Despith the limitations of retrospective analyses, the present study shows that thrombocytopenia is relatively common in acute coronary syndrome patients treated with UFH, but did not account for HIT associated complication, such as thrombosis. When clinicians recognize the development of HIT without a thrombocytopenia related disease, many will stop the use of heparin for its management.
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Fig. 1.
Serial platelet counts of 298 patients with non-HIT and 40 patients with HIT. The dotted lines indicate the mean±SD platelet count in non-HIT patients. The bold lines are shown for patients with HIT.
Table 1.
Patients including eligible group characteristics
| N of patients | % | |
|---|---|---|
| Patients | 554 | 100 |
| Age (years) | 69 (44～81) | |
| Sex | ||
| Male | 353 | 64 |
| Female | 201 | 36 |
| Presenting symptom(s)∗ | ||
| Chest pain | 466 | 84 |
| Dyspnea | 102 | 18 |
| Palpitation | 54 | 10 |
| Others | 20 | 4 |
| None | 95 | 17 |
| Final diagnosis | ||
| Myocardial infarction/unstable angina | 338† | 61 |
| Stable angina pectoris | 166 | 30 |
| Pulmonary thromboembolism | 11 | 2 |
| Arrhythmia | 30 | 5 |
| Others | 9 | 2 |
| Duration of heparin administration (days) 6 (1～41) | ||
Table 2.
Clinical characteistics of 338 patients with acute coronary syndrome
Table 3.
Correlation of average age, sex and average heparin use duration between HIT group & Non-HIT group
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