Platelet count trends and response to fondaparinux in a cohort of heparin-induced thrombocytopenia suspected patients af
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Platelet count trends and response to fondaparinux in a cohort of heparin‑induced thrombocytopenia suspected patients after pulmonary endarterectomy Ji‑Feng Li1,2,3,4 · Li‑Juan Wu5,6 · Ge‑Yi Wen4 · Rong‑Rong Zhou4 · Fang liu7 · Wei Wang4 · Su‑Qiao Yang1,2,3,4 · Juan‑Ni Gong1,2,3,4 · Ran Miao2,3,4 · Song Gu8 · Yan Liu8 · Yuan‑Hua Yang1,2,3,4
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract A definitive diagnosis of heparin-induced thrombocytopenia (HIT) is difficult to make, especially in patients undergoing cardiac surgery. In this retrospective cohort study, we assessed the platelet count trends and the response to fondaparinux in a population of patients of suspected HIT after pulmonary endarterectomy (PEA). Patients enrolled in this study were over the age of 18 years, and survived longer than 7 days after PEA between January 1, 2011 and December 31, 2015. HIT likelihood was assessed by the 4 T’s score and interpreted by our institutional algorithm. 54 patients were operated, and 49 patients met the inclusion criteria. Six patients met the criteria for suspected HIT and were treated with fondaparinux until the platelet recovered. No significant difference was observed of clinical characteristics between intermediate to high HIT likelihood patients (HIT SUSPECTED) and low HIT likelihood patients (NO HIT SUSPECTED). HIT SUSPECTED patients reached platelet count lowest later (about 5.5 days after PEA), while NO HIT SUSPECTED patients is about 4.0 days after PEA. Percentage of platelet counts decrease (> 50%) was larger than NO HIT SUSPECTED patients ( 50%) was larger than HIT negative patients (
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