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Heparin-Induced Thrombocytopenia A Comprehensive Clinical Review

Journal

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 67, Issue 21, Pages 2519-2532

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2016.02.073

Keywords

anticoagulant agents; antithrombin agents; argatroban; bivalirudin; cardiopulmonary bypass; platelets

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Heparin-induced thrombocytopenia is a profoundly dangerous, potentially lethal, immunologically mediated adverse drug reaction to unfractionated heparin or, less commonly, to low-molecular weight heparin. In this comprehensive review, the authors highlight heparin-induced thrombocytopenia's risk factors, clinical presentation, pathophysiology, diagnostic principles, and treatment. The authors place special emphasis on the management of patients requiring procedures using cardiopulmonary bypass or interventions in the catheterization laboratory. Clinical vigilance of this disease process is important to ensure its recognition, diagnosis, and treatment. Misdiagnosis of the syndrome, as well as misunderstanding of the disease process, continues to contribute to its morbidity and mortality. (C) 2016 by the American College of Cardiology Foundation.

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