Heparin-induced antibodies and cardiovascular risk in patients on dialysis

• DOI: 10.1160/th08-03-0144
• Publication Date: 2008-08-14T05:34:25Z
• Authors: Jodi B. Segal; Laura C. Plantinga; Nancy E. Fink; Jonathan S. Kerman; Thomas S. Kickler; Josef Coresh; Lawrence B. Gardner; Lars M. Asmis
• Keywords: Adult; Male; Risk; Heparin; Platelet Count; 2720 Hematology; 610 Medicine & health; Middle Aged; Thrombocytopenia; Antibodies; Immunoglobulin A; 3. Good health; Immunoglobulin M; Cardiovascular Diseases; Renal Dialysis; Immunoglobulin G; 10032 Clinic for Oncology and Hematology; Humans; Female; Peritoneal Dialysis; Aged

Summary The clinical relevance of heparin-induced antibodies (HIA) in the absence thrombocytopenia remains to be defined. aims this study were (i) determine prevalence HIA patients treated by dialysis, (ii) and (HIT), (iii) test whether are associated with adverse outcomes. Sera from 740 hemodialysis (HD, n=596) peritoneal dialysis (PD, n=144) tested for (IgG, IgA or IgM) masked investigators at approximately six months after enrolment Choices Healthy Outcomes Caring End-Stage Renal Disease (CHOICE) study. We assessed, time-to-event Cox proportional hazards models, presence predicted any four outcomes: arterial cardiovascular events, venous thromboembolism, vascular access occlusion mortality. was 10.3% overall. positivity did not predict development outcomes over a mean follow-up 3.6 years, hazard ratios events 0.98 (95% confidence interval 0.70–1.37), thromboembolism 1.39 (0.17–11.5), 0.82 (0.40–1.71), mortality 1.18 (0.85–1.64). Chronic intermittent heparin exposure high seroprevalence HIA. In these an independent risk factor Our data do suggest that should monitored thrombocytopenia.