title: Comparative Analysis of the Suspected Heparin-Induced Thrombocytopenia Level in Korea.
abstract: The primary objective of our study was to evaluate the frequency of suspected heparin-induced thrombocytopenia (HIT) among patients treated with different formulations of heparin and investigate the factors that affect the incidence of HIT. This study is an electronic medical record (EMR)-based large-scale retrospective cohort study conducted from 2009 to 2014 in Korea. After hospitalization, patient platelet count was determined before heparin was prescribed, and all platelet count values obtained during hospitalization were extracted. Suspected HIT was estimated by three 4Ts scores (acute thrombocytopenia, timing onset and other possible causes), which when combined yielded a high probability of HIT. Among 6046 patients enrolled in this study, HIT was suspected in 641 cases (10.6%) and a statistically significant increase in HIT incidence rate was observed for three heparins used (p < 0.001). Dalteparin (HR = 0.55, p = 0.036) and enoxaparin (HR = 0.40, p < 0.001) showed a relatively low HIT incidence rate, compared to unfractionated heparin. Majority of suspected HIT cases (76.9 and 66.7%) occurred in days 8-10 and 5-7 of dalteparin and enoxaparin treatments, respectively. Most of the patients medicated with dalteparin were cancer patients; however, no statistically significant relationship was observed between HIT occurrence and cancer. HIT can cause serious complications, making early diagnosis crucial. Clinical practitioners first prescribing heparin should focus on preventing and detecting complications early by conducting frequent, regular platelet counts before and after heparin administration.
authors.affiliation: Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.|Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hun-Sung
authors.initials: HS
authors.lastname: Kim
authors.affiliation: College of Pharmacy, Sookmyung Women's University, Seoul, Korea.
authors.forename: Hyunah
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Yoo Jin
authors.initials: YJ
authors.lastname: Jeong
authors.affiliation: Clinical Research Coordinating Center, Catholic Medical Center, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hyunyong
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Hyeon Woo
authors.initials: HW
authors.lastname: Yim
authors.affiliation: Division of Vascular and Transplant Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Ji Il
authors.initials: JI
authors.lastname: Kim
authors.affiliation: Division of Vascular and Transplant Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: In Sung
authors.initials: IS
authors.lastname: Moon
authors.affiliation: Division of Vascular and Transplant Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors.forename: Jang-Yong
authors.initials: JY
authors.lastname: Kim
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects* / Q000737:chemistry; D017985:Dalteparin / Q000009:adverse effects* / Q000737:chemistry; D004339:Drug Compounding; D016903:Drug Monitoring / Q000379:methods; D017984:Enoxaparin / Q000009:adverse effects* / Q000737:chemistry; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D017762:Nadroparin / Q000009:adverse effects* / Q000737:chemistry; D010976:Platelet Count; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013921:Thrombocytopenia / Q000097:blood / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D013997:Time Factors
chemical_list: D000925:Anticoagulants; D017984:Enoxaparin; D017762:Nadroparin; D017985:Dalteparin