title: Is the incidence of heparin-induced thrombocytopenia affected by the increased use of heparin for VTE prophylaxis?
abstract: BACKGROUND
  The increased exposure to heparin products for thromboprophylaxis against VTE in hospitalized patients raises concerns for an increase in the incidence of heparin-induced thrombocytopenia(HIT).
  
  
  METHODS
  We analyzed, among 90,875 patients exposed to heparin products between 2005 and 2009, the number of hematologic consultations for thrombocytopenia, requests for heparin induced antibodies by enzyme-linked immunosorbent assay, and cases given a diagnosis of HIT by the hematology consult service.
  
  
  RESULTS
  We observed that despite a doubling in the number of patients receiving pharmacoprophylaxis with heparin, there was no significant increase in the number of consultations for thrombocytopenia,the number of requests for HIT tests, the number of positive HIT test results, or the number of HIT diagnoses. The number of cases of HIT was low and represented < 0.1% of patients exposed to heparin.
  
  
  CONCLUSIONS
  We conclude that concerns about HIT should not be a limiting factor for the systematic implementation of heparin-based VTE prophylaxis.
authors.affiliation: Department of Medicine, Atlanta, GA.
authors.forename: Amy
authors.initials: A
authors.lastname: Zhou
authors.affiliation: Department of Pathology, Atlanta, GA.
authors.forename: Anne
authors.initials: A
authors.lastname: Winkler
authors.affiliation: Emory University Hospital Department of Pharmacy, Atlanta, GA.
authors.forename: Amir
authors.initials: A
authors.lastname: Emamifar
authors.affiliation: Department of Medicine, Atlanta, GA.
authors.forename: Bryce
authors.initials: B
authors.lastname: Gartland
authors.affiliation: Department of Pathology, Atlanta, GA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Duncan
authors.affiliation: Department of Hematology and Medical Oncology and the Winship Cancer Institute of Emory University, Atlanta, GA.
authors.forename: Ana
authors.initials: A
authors.lastname: Antun
authors.affiliation: Department of Hematology and Medical Oncology and the Winship Cancer Institute of Emory University, Atlanta, GA.
authors.forename: Martha
authors.initials: M
authors.lastname: Arellano
authors.affiliation: Department of Hematology and Medical Oncology and the Winship Cancer Institute of Emory University, Atlanta, GA.
authors.forename: G Allen
authors.initials: GA
authors.lastname: Tindol
authors.affiliation: Department of Anesthesiology and Critical Care, Atlanta, GA.
authors.forename: Jerrold H
authors.initials: JH
authors.lastname: Levy
authors.affiliation: Department of Medicine, Atlanta, GA.
authors.forename: William A
authors.initials: WA
authors.lastname: Bornstein
authors.affiliation: Division of Gynecologic Oncology and the Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA.
authors.forename: Ira R
authors.initials: IR
authors.lastname: Horowitz
authors.affiliation: Department of Hematology and Medical Oncology and the Winship Cancer Institute of Emory University, Atlanta, GA. Electronic address: hkhoury@emory.edu.
authors.forename: Hanna Jean
authors.initials: HJ
authors.lastname: Khoury
mesh_terms: D000328:Adult; D000368:Aged; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000453:epidemiology*; D054556:Venous Thromboembolism / Q000517:prevention & control*
chemical_list: D006493:Heparin