PMID- 16857993
OWN - NLM
STAT- MEDLINE
DCOM- 20061128
LR  - 20220321
IS  - 0006-4971 (Print)
IS  - 0006-4971 (Linking)
VI  - 108
IP  - 9
DP  - 2006 Nov 1
TI  - Gender imbalance and risk factor interactions in heparin-induced 
      thrombocytopenia.
PG  - 2937-41
AB  - Heparin-induced thrombocytopenia (HIT) is caused by antibodies against a "self" 
      protein-platelet factor 4-bound to heparin. We observed an overrepresentation of 
      the female gender in 290 patients who developed HIT after cardiac or orthopedic 
      surgery compared with the representation found in national databases (study 1). 
      Therefore, we investigated gender imbalance in HIT by logistic regression 
      analysis of a randomized controlled trial of unfractionated heparin (UFH) and 
      low-molecular-weight heparin (LMWH) (study 2), and we analyzed individual patient 
      data from 7 prospective studies comparing HIT frequency between UFH and LMWH, 
      evaluating effects of gender, heparin (UFH vs LMWH), and patient type (surgical 
      vs medical) (study 3). All 3 studies showed female overrepresentation, which for 
      study 3 was a common odds ratio (OR) of 2.37 (95% confidence interval [95% CI], 
      1.37-4.09; P = .0015). Study 3 also showed an interaction between gender, 
      heparin, and patient type. Although UFH was more likely than LMWH to cause HIT (P 
      < .0001), this effect was predominantly seen in women compared with men (common 
      OR, 9.22 vs 1.83; P = .020) and in surgical patients compared with medical 
      patients (common OR, 13.93 vs 1.75; P = .005). We conclude that females are at 
      greater risk for HIT and that using LMWH to prevent HIT may have greatest 
      absolute benefit in females undergoing surgical thromboprophylaxis.
FAU - Warkentin, Theodore E
AU  - Warkentin TE
AD  - Department of Pathology, Hamilton Regional Laboratory Medicine Program, Rm 
      1-180A, Hamilton Health Sciences, Hamilton General Site, McMaster University, 237 
      Barton St E, Hamilton, ON L8L2X2 Canada. twarken@mcmaster.ca
FAU - Sheppard, Jo-Ann I
AU  - Sheppard JA
FAU - Sigouin, Christopher S
AU  - Sigouin CS
FAU - Kohlmann, Thomas
AU  - Kohlmann T
FAU - Eichler, Petra
AU  - Eichler P
FAU - Greinacher, Andreas
AU  - Greinacher A
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20060720
PL  - United States
TA  - Blood
JT  - Blood
JID - 7603509
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Databases, Factual
MH  - Female
MH  - Heparin/*adverse effects
MH  - Humans
MH  - Male
MH  - Randomized Controlled Trials as Topic
MH  - Regression Analysis
MH  - Risk Factors
MH  - *Sex Characteristics
MH  - Surgical Procedures, Operative
MH  - Thrombocytopenia/*chemically induced/*epidemiology
EDAT- 2006/07/22 09:00
MHDA- 2006/12/09 09:00
CRDT- 2006/07/22 09:00
PHST- 2006/07/22 09:00 [pubmed]
PHST- 2006/12/09 09:00 [medline]
PHST- 2006/07/22 09:00 [entrez]
AID - S0006-4971(20)52377-X [pii]
AID - 10.1182/blood-2005-11-012450 [doi]
PST - ppublish
SO  - Blood. 2006 Nov 1;108(9):2937-41. doi: 10.1182/blood-2005-11-012450. Epub 2006 
      Jul 20.