FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 303:902-907 October 16, 1980 Number 16 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

We performed a prospective, double-blind study of the incidence of thrombocytopenia in 149 patients randomly assigned to treatment with one of three heparin preparations--from bovine lung from intestinal-mucosa A, or from intestinal-mucosa O. Thrombocytopenia developed in 21 patients (platelets, < 100 x 10(9) per liter): 13 of the 50 receiving bovine lung heparin, four of 45 receiving intestinal-mucosa-A heparin, and four of 54 receiving intestinal-musoca-O heparin (P < 0.005). There was a significantly increased incidence of thrombocytopenia in the bovine-lung group (P < 0.002); estimated incidence rates after nine days of treatment were 24 per cent in this group and 7 per cent in the combined intestinal-mucosa A and O groups. Thrombocytopenia appeared in the bovine-lung group on days 3 to 16, in the intestinal-mucosa-A groups on Days 4 to 12, and in the intestinal-mucosa-O group on Days 3 to 7; it disappeared in all groups three to eight days after discontinuation of heparin. A total of 121 patients were subsequently given warfarin for four to six months, and thrombocytopenia was not observed.

This article has been cited by other articles:

• Bartholomew, J. R. (2005). Transition to an Oral Anticoagulant in Patients With Heparin-Induced Thrombocytopenia. Chest 127: 27S-34S [Abstract] [Full Text]  
• Gurbuz, A. T., Elliott, W. G., Zia, A. A. (2005). Heparin-induced thrombocytopenia in the cardiovascular patient: diagnostic and treatment guidelines. Eur. J. Cardiothorac. Surg. 27: 138-149 [Abstract] [Full Text]  
• Rice, L., Attisha, W. K., Francis, J. L. (2003). Delayed-Onset Heparin-Induced Thrombocytopenia. ANN INTERN MED 139: 790-791 [Full Text]  
• Warkentin, T. E. (2003). Pork or beef?. Ann. Thorac. Surg. 75: 15-16 [Full Text]  
• Francis, J. L., Palmer, G. J. III, Moroose, R., Drexler, A. (2003). Comparison of bovine and porcine heparin in heparin antibody formation after cardiac surgery. Ann. Thorac. Surg. 75: 17-22 [Abstract] [Full Text]  
• Deitcher, S. R, Carman, T. L (2001). Heparin-induced thrombocytopenia: natural history, diagnosis, and management. Vasc Med 6: 113-119 [Abstract]  
• Hyers, T. M., Agnelli, G., Hull, R. D., Morris, T. A., Samama, M., Tapson, V., Weg, J. G. (2001). Antithrombotic Therapy for Venous Thromboembolic Disease. Chest 119: 176S-193S [Full Text]  
• Dupont, E. L., Gahtan, V., Mills, J. L. (1999). Heparin-Induced Thrombocytopenia: An Jatrogenic Catastrophe. VASC ENDOVASCULAR SURG 33: 43-49 [Abstract]  
• Renaudineau, Y, Revelen, R, Bordron, A, Mottier, D, Youinou, P, Le Corre, R (1998). Two populations of endothelial cell antibodies cross-react with heparin. Lupus 7: 86-94 [Abstract]  
• Farag, S. S., Savoia, H., O'Malley, C. J., McGrath, K. M. (1997). Lack of In Vitro Cross-Reactivity Predicts Safety of Low-Molecular Weight Heparins in Heparin-Induced Thrombocytopenia. CLIN APPL THROMB HEMOST 3: 58-62 [Abstract]  
• Batra, M. K., Adolph, M. D., Thornton, J. C., Byramjee, A. M., Oliver, A. O., Schreiber, H. (1996). Antithrombin III Deficiency and White Clot Syndrome: Case Reports and Literature Review. VASC ENDOVASCULAR SURG 30: 37-44 [Abstract]  
• Van Damme, H., Damas, P., David, J.L., Limet, R. (1990). Heparin-Induced Thrombocytopenia: A Case Report. ANGIOLOGY 41: 1075-1081 [Abstract]  
• Celoria, G. M., Steingart, R. H., Banson, B., Friedmann, P., Rhee, S. W., Berman, J. A. (1988). Coumarin Skin Necrosis in a Patient with Heparin-Induced Thrombocytopenia A Case Report. ANGIOLOGY 39: 915-920 [Abstract]