Heparin-associated thrombocytopenia: a comparison of three heparin preparations.
We performed a prospective, double-blind study of the incidence of thrombocytopenia in 149 patients randomly assigned to treatment with one of three heparin preparations--from bovine lung from intestinal-mucosa A, or from intestinal-mucosa O. Thrombocytopenia developed in 21 patients (platelets, < 100 x 10(9) per liter): 13 of the 50 receiving bovine lung heparin, four of 45 receiving intestinal-mucosa-A heparin, and four of 54 receiving intestinal-musoca-O heparin (P < 0.005). There was a significantly increased incidence of thrombocytopenia in the bovine-lung group (P < 0.002); estimated incidence rates after nine days of treatment were 24 per cent in this group and 7 per cent in the combined intestinal-mucosa A and O groups. Thrombocytopenia appeared in the bovine-lung group on days 3 to 16, in the intestinal-mucosa-A groups on Days 4 to 12, and in the intestinal-mucosa-O group on Days 3 to 7; it disappeared in all groups three to eight days after discontinuation of heparin. A total of 121 patients were subsequently given warfarin for four to six months, and thrombocytopenia was not observed.
D000818:Animals; D001780:Blood Coagulation Tests; D002417:Cattle; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D005260:Female; D006493:Heparin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007413:Intestinal Mucosa; D008168:Lung; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies; D013921:Thrombocytopenia / Q000139:chemically induced*; D013997:Time Factors; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use
D014859:Warfarin; D006493:Heparin