title: Is low serum albumin level a significant predictor for the development of heparin-induced thrombocytopenia-thrombosis?
abstract: The present study investigates the effect of albumin levels in patients who have developed heparin-induced thrombocytopenia (HIT) and heparin-induced thrombocytopenia-thrombosis (HITT). A retrospective observational cohort study was conducted at King Abudlaziz Medical City (KAMC), a university teaching hospital, on patients diagnosed with HIT between June 2013 and December 2014. Clinical and laboratory findings were used to confirm HIT. Albumin levels were reported on admission as baseline and during HIT occurrence. Twenty-eight patients were identified as HIT positive by enzyme-linked immunosorbent assay (ELISA), with a cutoff value of ≥1 optical density units and pretest probability "4Ts" score of ≥4. Of the 28 patients, nine (32%) developed HITT. Demographic characteristics of the patients who developed HIT and HITT were similar. The mean albumin level for patients who developed HITT was significantly lower than that for patients who developed HIT (p < 0.001). Our findings suggest that patients with low serum albumin levels are at greater risk of developing HITT. This finding awaits confirmation in larger prospective clinical trials.
authors.affiliation: College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia. faleidan@gmail.com.|Department of Pharmaceutical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia. faleidan@gmail.com.
authors.forename: Fahad A S
authors.initials: FAS
authors.lastname: Al-Eidan
authors.affiliation: Department of Pharmaceutical Care, King Abdulaziz Medical City, Riyadh, Saudi Arabia.|College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
authors.forename: J A
authors.initials: JA
authors.lastname: Al-Gramish
authors.affiliation: College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.|Department of Surgery, King Abdulaziz Medical City, Riyadh, Saudi Arabia.
authors.forename: H A
authors.initials: HA
authors.lastname: Al-Zamil
authors.affiliation: Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
authors.forename: M A
authors.initials: MA
authors.lastname: Crowther
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006493:Heparin / Q000009:adverse effects; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012709:Serum Albumin / Q000378:metabolism*; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis*; D013927:Thrombosis / Q000097:blood / Q000139:chemically induced / Q000175:diagnosis*
chemical_list: D000925:Anticoagulants; D012709:Serum Albumin; D006493:Heparin
keywords: Adverse drug reactions; Risk factors; Serum albumin; Thrombocytopenia; Thrombosis