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Production of Anti-platelet Factor 4/Heparin Complex Antibodies After Cardiovascular Surgery.

Abstract
To study the production of anti-platelet factor 4 (anti-PF4)/heparin complex antibodies of Ig (immunoglobulin) G/IgA/IgM using enzyme-linked immunosorbent assay (ELISA; heparin-induced thrombocytopenia [HIT] antibodies) in 79 patients undergoing cardiovascular surgery, we employed Δoptical density (OD) as a marker of HIT-antibody production. The ΔODs were calculated from the differences in the ODs using ELISA. Patient were classified into 3 ΔOD ranges: ΔOD ≥ 1.0, ΔOD ≥ 0.4 to <1.0, and ΔOD < 0.4. The underlying disease, time course of the postoperative platelet count, D-dimer level, postoperative brain magnetic resonance imaging (MRI), use of cardiopulmonary bypass and postoperative thrombocytosis were not considered for the 3 ΔOD classifications. None of the 6 patients with ΔOD ≥ 1 .0 and a positive functional assay was diagnosed with HIT due to the absence of HIT-derived thrombocytopenia. In conclusion, HIT-antibody production increased until day 7 after heparin cessation and reached a trace level on day 14. It was demonstrated that HIT-antibody production is in remission unless there is any evidence of a further increase during the second week postsurgery.
AuthorsTakefumi Matsuo, Shinya Motohashi, Keiko Wanaka, Jeanine M Walenga
JournalClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis (Clin Appl Thromb Hemost) Vol. 21 Issue 2 Pg. 177-80 (Mar 2015) ISSN: 1938-2723 [Electronic] United States
PMID24203352 (Publication Type: Clinical Trial, Journal Article)
Copyright© The Author(s) 2013.
Chemical References
  • Autoantibodies
  • Platelet Factor 4
  • Heparin
Topics
  • Autoantibodies (blood)
  • Cardiopulmonary Bypass (adverse effects)
  • Female
  • Heparin (administration & dosage, adverse effects, pharmacokinetics)
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Platelet Factor 4
  • Postoperative Complications (blood, diagnostic imaging)
  • Radiography
  • Thrombocytopenia (blood, chemically induced, diagnostic imaging)

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