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Article Dans Une Revue Thrombosis and Haemostasis Année : 2020

Comparative Analysis of a French Prospective Series of 144 Patients with Heparin-Induced Thrombocytopenia (FRIGTIH) and the Literature

1 Service d'hématologie [Tours]
2 GICC EA 7501 - Groupe innovation et ciblage cellulaire (GICC), EA 7501 [2018-...]
3 CHU Trousseau [Tours]
4 LVTS (UMR_S_1148 / U1148) - Laboratoire de Recherche Vasculaire Translationnelle
5 IMEA - Institut de médecine et d'épidémiologie appliquée [AP-HP Hôpital Bichat-Claude Bernard]
6 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
7 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
8 IRTOMIT [Poitiers] - Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques [U 1082]
9 HEGP - Hôpital Européen Georges Pompidou [APHP]
10 CHU Clermont-Ferrand
11 UNH - Unité de Nutrition Humaine
12 Service d'Hématologie Clinique (CHU de Dijon)
13 SBRI - Institut cellule souche et cerveau / Stem Cell and Brain Research Institute
14 UT - Université de Tours
15 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
16 CIC-EC 1408 - Centre d'Investigation Clinique - Epidémiologie Clinique [CHU Saint-Etienne]
17 CHU Tenon [AP-HP]
18 CRSA - Centre de Recherche Saint-Antoine
19 AP-HP. Université Paris Saclay
20 HITH - U1176 Inserm - CHU Bicêtre - Hémostase, Inflammation, Thrombose
21 CHU Bordeaux
22 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
23 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
24 Hôpital Cochin [AP-HP]
25 LVTS (UMR_S_1148 / U1148) - Laboratoire de Recherche Vasculaire Translationnelle
26 Hôpital Beaujon [AP-HP]
27 CIC - Centre d'Investigation Clinique [Rennes]
28 Hôpital Louis Pradel [CHU - HCL]
29 CHU ST-E - Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne]
30 SPHERE - MethodS in Patients-centered outcomes and HEalth ResEarch
31 CIC - Centre d’Investigation Clinique [Tours] CIC 1415
Pierre Weber
  • Fonction : Auteur
Christine Mouton
  • Fonction : Auteur
Christine Biron
  • Fonction : Auteur

Résumé

Abstract Background Heparin-induced thrombocytopenia (HIT) is a rare complication of heparin treatments, and only a few large patient cohorts have been reported. In this study, biological and clinical data from 144 French patients with HIT were analyzed in comparison with the literature. Methods The diagnosis of HIT was confirmed in all patients by an immunoassay combined with serotonin release assay. In the literature, only cohorts of at least 20 HIT patients published from 1992 were selected for a comparative analysis. Results Two-thirds of patients were hospitalized in surgery and most were treated with unfractionated heparin (83.2% vs. 16.8% with low molecular weight heparin only). Thrombotic events in 54 patients (39.7%) were mainly venous (41/54). However, arterial thrombosis was more frequent after cardiac surgery (13.2% vs. 2.4% in other surgeries, p = 0.042) with a shorter recovery time (median = 3 vs. 5 days, p < 0.001). The mortality rate was lower in our series than in the 22 selected published studies (median = 6.3% vs. 15.9%). Three genetic polymorphisms were also studied and homozygous subjects FcγRIIA RR were more frequent in patients with thrombosis (37.8 vs. 18.2% in those without thrombosis, p = 0.03). Conclusion This study shows that the mortality rate due to HIT has recently decreased in France, possibly due to earlier diagnosis and improved medical care. It also confirms the strong association between polymorphism FcγRIIA H131R and thrombosis in HIT.
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Dates et versions

hal-04459852 , version 1 (15-02-2024)

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Yves Gruel, Caroline Vayne, Jérôme Rollin, Pierre Weber, Dorothée Faille, et al.. Comparative Analysis of a French Prospective Series of 144 Patients with Heparin-Induced Thrombocytopenia (FRIGTIH) and the Literature. Thrombosis and Haemostasis, 2020, 120 (07), pp.1096-1107. ⟨10.1055/s-0040-1712957⟩. ⟨hal-04459852⟩
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