Can thromboelastography predict which patients with heparin-induced thrombocytopenia may suffer thrombotic complications of type II?

Abstract

Despite the existence of several sensitive functional and antigen assays used for the diagnosis of heparin-induced thrombocytopenia (HIT), an additional assessment of the patient's hemostatic status, in order to predict the thrombotic complications of the malevolent HIT type II, has become necessary. Herein below, we present the findings of thromboelastography (TEG) in a post-cardiac-surgery patient with the clinical diagnosis of HIT type II and false negative tests for heparin antibodies. We have reached the conclusion that TEG may prove to be a useful supplementary method to predict those HIT patients who may suffer complications of HIT type II.

An evaluation of monitoring possibilities of argatroban using rotational thromboelastometry and activated partial thromboplastin time

“…There are no reports on TEG ® /ROTEM ® during PCI, but Kieta et al 19 monitored argatroban successfully in a patient with HIT during coronary revascularization with TEG ® . TEG ® has also been proposed as a tool to individualize the HIT treatment strategy in patients undergoing cardiac surgery, 20–23 with possible cost reductions secondary to a decreased use of blood products and expensive coagulation factor concentrates 7 …”

Role of Thrombelastography (TEG) in Risk Assessment and Guidance of Antithrombotic Therapy in Patients with Coronary Artery Disease

“…TEG may be useful in identifying patients that develop heparin-induced thrombocytopenia (HIT) after cardiac surgery (1-3% of patients) [Warkentin and Greinacher, 2003], in order to guide early treatment and decrease mortality [Kouerinis et al, 2007]. A study is currently being conducted to assess the role of TEG in determining the risk of bleeding or thromboembolic complications in a group of patients diagnosed to have HIT postcardiac surgery [Kouerinis et al, 2008].…”