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Diagnosis and Treatment |

Heparin-Associated Thrombocytopenia

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▸Requests for reprints should be addressed to John G. Kelton, M.D.; Room 2N34, McMaster University Medical Centre, 1200 Main Street West; Hamilton, Ontario L8N 3Z5, Canada

Hamilton, Ontario, Canada

© 1984 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1984;100(4):535-540. doi:10.7326/0003-4819-100-4-535
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Heparin-associated thrombocytopenia is a relatively common complication of heparin therapy occurring in approximately 5% of the patients who receive this drug. The incidence is higher with bovine heparin than with porcine heparin. Onset of heparin-associated thrombocytopenia usually occurs 6 to 12 days after initiation of treatment and by itself has a low morbidity. Heparin-associated thrombocytopenia plus arterial thrombosis can cause major complications including stroke, heart attack, and death. The incidence of heparin-associated thrombocytopenia plus arterial thrombosis is lower than that for heparin-associated thrombocytopenia alone. The diagnosis of heparin-associated thrombocytopenia remains one of exclusion, but testing for the presence of a heparin-dependent platelet-aggregating factor may prove to be useful. Analysis of the time of onset suggests a strategy for prevention. Oral anticoagulants could be started concomitantly with the heparin so that it could be discontinued in several days. This approach may prevent most episodes of heparin-associated thrombocytopenia.





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