PMID- 21676169
OWN - NLM
STAT- MEDLINE
DCOM- 20120116
LR  - 20230829
IS  - 1538-7836 (Electronic)
IS  - 1538-7836 (Linking)
VI  - 9
IP  - 9
DP  - 2011 Sep
TI  - Heparin-associated thrombocytopenia in 24,401 patients with venous 
      thromboembolism: findings from the RIETE Registry.
PG  - 1761-8
LID - 10.1111/j.1538-7836.2011.04402.x [doi]
AB  - BACKGROUND: Whether the treatment of venous thromboembolism (VTE) with 
      unfractionated heparin (UFH) confers a higher risk of thrombocytopenia than does 
      treatment with low molecular weight heparin (LMWH) remains controversial, and 
      very few data are available from routine clinical practice. OBJECTIVES: We 
      assessed the incidence, risk factors and prognosis of heparin-associated 
      thrombocytopenia (HAT) according to the type of heparin therapy, UFH or LMWH. 
      PATIENTS/METHODS: Data were obtained from the international prospective Registro 
      Informatizado de la Enfermedad TromboEmbolica venosa (RIETE), which included 
      25,369 patients with confirmed VTE until February 2009. Among them, 24,401 
      patients were treated either with UFH or with LMWH, and had available information 
      about the 6-month occurrence of confirmed thrombocytopenia, defined as a platelet 
      count </= 150,000 mm(-3) . RESULTS: One hundred and forty-one patients receiving 
      UFH and/or LMWH developed thrombocytopenia within a 6-month period. The incidence 
      of HAT was significantly higher in the UFH group (1.36%, 95% confidence interval 
      [CI] 0.79-2.17) than in the LMWH group (0.54%, 95% CI 0.44-0.64). As compared 
      with LMWH, UFH significantly increased the risk of HAT in female patients 
      (adjusted hazard ratio [HR] 4.90%, 95% CI 2.58-9.31, P = 0.001) but not in male 
      patients (adjusted HR 1.60%, 95% CI 0.64-3.97, P = 0.31); P = 0.027 for 
      comparison. In each gender, the UFH-associated excess risk was confined to 
      patients with VTE unrelated to cancer. The poor prognosis of patients with 
      thrombocytopenia was not influenced by the type of heparin therapy. CONCLUSIONS: 
      In routine clinical practice, treatment of VTE with UFH seems to confer a higher 
      risk of thrombocytopenia than does treatment with LMWH, especially in women and 
      non-cancerous patients.
CI  - (c) 2011 International Society on Thrombosis and Haemostasis.
FAU - Falvo, N
AU  - Falvo N
AD  - Centre Hospitalier Universitaire de Dijon, Service de Medecine Interne-Unite 
      Maladie Thromboembolique, Dijon, France. nicolas.falvo@chu-dijon.fr
FAU - Bonithon-Kopp, C
AU  - Bonithon-Kopp C
FAU - Rivron Guillot, K
AU  - Rivron Guillot K
FAU - Todoli, J A
AU  - Todoli JA
FAU - Jimenez-Gil, M
AU  - Jimenez-Gil M
FAU - Di Micco, P
AU  - Di Micco P
FAU - Monreal, M
AU  - Monreal M
CN  - RIETE Investigators
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Thromb Haemost
JT  - Journal of thrombosis and haemostasis : JTH
JID - 101170508
RN  - 0 (Heparin, Low-Molecular-Weight)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Aged
MH  - Cohort Studies
MH  - Female
MH  - Heparin/*adverse effects
MH  - Heparin, Low-Molecular-Weight/adverse effects
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prospective Studies
MH  - Registries
MH  - Risk Factors
MH  - Sex Factors
MH  - Thrombocytopenia/*chemically induced/epidemiology/etiology
MH  - Venous Thromboembolism/*drug therapy
FIR - Monreal, M
IR  - Monreal M
FIR - Decousus, H
IR  - Decousus H
FIR - Prandoni, P
IR  - Prandoni P
FIR - Brenner, B
IR  - Brenner B
FIR - Barba, R
IR  - Barba R
FIR - Di Micco, P
IR  - Di Micco P
FIR - Rivron-Guillot, K
IR  - Rivron-Guillot K
FIR - Bosevski, M
IR  - Bosevski M
EDAT- 2011/06/17 06:00
MHDA- 2012/01/17 06:00
CRDT- 2011/06/17 06:00
PHST- 2011/06/17 06:00 [entrez]
PHST- 2011/06/17 06:00 [pubmed]
PHST- 2012/01/17 06:00 [medline]
AID - S1538-7836(22)07112-4 [pii]
AID - 10.1111/j.1538-7836.2011.04402.x [doi]
PST - ppublish
SO  - J Thromb Haemost. 2011 Sep;9(9):1761-8. doi: 10.1111/j.1538-7836.2011.04402.x.