ArticleJAMA network open2024
Accuracy of Diagnosing Heparin-Induced Thrombocytopenia.
Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The Challenge of Detecting Heparin-induced Thrombocytopenia (HIT) in a Developing Country: A Systematic Review.Cardiovascular & hematological agents in medicinal chemistry · 2025Pooled it
- Development of an integrated clinical-laboratory scoring system for accurate HIT diagnosis.Blood advances · 2026Article
- Heparin Anticoagulant Therapy and Its Monitoring.Biomolecules · 2026Review
- A combination of 2 rapid immunoassays significantly improves diagnostic sensitivity for heparin-induced thrombocytopenia.American journal of clinical pathology · 2026Observational
- Multi-Target Anticoagulant Regulation by Peptides from Medicinal Leeches: A Unique Natural Strategy against Thrombosis.Pharmaceutical research · 2026Review
- Outcomes of patients with suspected heparin-induced thrombocytopenia in a contemporary multicenter cohort.Blood advances · 2025Article
- The Differential Diagnosis of Thromobocytopenia.Deutsches Arzteblatt international · 2025Review
- Hyperfibrinolysis during intra-aortic balloon pump support: a case report on targeted tranexamic acid therapy.Frontiers in cardiovascular medicine · 2025Article
- Anti-PF4/ Heparin Antibodies Early Seroconversion in Hip Fracture Patients Receiving Low Molecular Weight Heparin Prophylaxis: a Pilot Study of 100 Consecutive Patients.The archives of bone and joint surgery · 2025Article
- Practical guide to the diagnosis and management of heparin-induced thrombocytopenia.Hematology. American Society of Hematology. Education Program · 2024Review
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Heparin-induced thrombocytopenia (HIT) is a life-threatening condition that requires urgent diagnostic clarification. However, knowledge of the diagnostic utility of the recommended diagnostic tests is limited in clinical practice. Objective: To evaluate the current diagnostic practice for managing the suspicion of HIT. Design, Setting, and Participants: This prospective diagnostic study was conducted from January 2018 to May 2021 among consecutive patients with suspected HIT from 11 study centers in Switzerland, Germany, and the United States. Detailed clinical data and laboratory information were recorded. Platelet factor 4/heparin antibodies were quantified using an automated chemiluminescent immunoassay (CLIA). A washed-platelet heparin-induced platelet activation (HIPA) test was used as a reference standard to define HIT. Exposures: Suspicion of HIT. Main Outcomes and Measures: The primary outcome was the diagnostic accuracy of the 4Ts score, the CLIA, and the recommended algorithm serially combining both tests. Results: Of 1448 patients included between 2018 and 2021, 1318 were available for the current analysis (median [IQR] age, 67 [57-75] years; 849 [64.6%] male). HIPA was positive in 111 patients (prevalence, 8.4%). The most frequent setting was intensive care unit (487 [37.0%]) or cardiovascular surgery (434 [33.0%]). The 4Ts score was low risk in 625 patients (46.8%). By 2 × 2 table, the numbers of patients with false-negative results were 10 (9.0%; 4Ts score), 5 (4.5%; CLIA), and 15 (13.5%; recommended diagnostic algorithm). The numbers of patients with false-positive results were 592 (49.0%; 4Ts score), 73 (6.0%; CLIA), and 50 (4.1%; recommended diagnostic algorithm), respectively. Conclusions and Relevance: In this diagnostic study of patients suspected of having HIT, when the recommended diagnostic algorithm was used in clinical practice, antibody testing was required in half the patients. A substantial number of patients were, however, still misclassified, which could lead to delayed diagnosis or overtreatment. Development of improved diagnostic algorithms for HIT diagnosis should be pursued.
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