Heparin-Induced Thrombocytopenia: A Comprehensive Clinical Review

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• 作者：Benjamin S. Salter ; DO^a ; ^{benjamin.salter@mountsinai.org" class="auth_mail" title="E-mail the corresponding author} ; Menachem M. Weiner ; MD^a ; Muoi A. Trinh ; MD^a ; Joshua Heller ; MD^a ; Adam S. Evans ; MD^a ; David H. Adams ; MD^b ; Gregory W. Fischer ; MD^a
• 关键词：anticoagulant agents ; antithrombin agents ; argatroban ; bivalirudin ; cardiopulmonary bypass ; platelets
• 刊名：Journal of the American College of Cardiology
• 出版年：2016
• 出版时间：31 May 2016
• 年：2016
• 卷：67
• 期：21
• 页码：2519-2532
• 全文大小：547 K

文摘

Heparin-induced thrombocytopenia is a profoundly dangerous, potentially lethal, immunologically mediated adverse drug reaction to unfractionated heparin or, less commonly, to low–molecular weight heparin. In this comprehensive review, the authors highlight heparin-induced thrombocytopenia’s risk factors, clinical presentation, pathophysiology, diagnostic principles, and treatment. The authors place special emphasis on the management of patients requiring procedures using cardiopulmonary bypass or interventions in the catheterization laboratory. Clinical vigilance of this disease process is important to ensure its recognition, diagnosis, and treatment. Misdiagnosis of the syndrome, as well as misunderstanding of the disease process, continues to contribute to its morbidity and mortality.