Elevated heparin-induced antibodies are more common in diabetic patients with vascular disease

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dc.contributor.author Naoum, Joseph J.
dc.contributor.author Chamoun, Nibal R.
dc.contributor.author Patel, Mitul S.
dc.contributor.author Street, Tiffany K.
dc.contributor.author Haydar, Mazen
dc.contributor.author Bismuth, Jean
dc.contributor.author El-Sayed, Hosam F.
dc.contributor.author Davies, Mark G.
dc.contributor.author Lumsden, Alan B.
dc.contributor.author Peden, Eric K.
dc.date.accessioned 2016-09-27T06:58:21Z
dc.date.available 2016-09-27T06:58:21Z
dc.date.copyright 2014 en_US
dc.date.issued 2016-09-27
dc.identifier.issn 2090-1488 en_US
dc.identifier.uri http://hdl.handle.net/10725/4414
dc.description.abstract Background. Hypercoagulable disorders can lead to deep vein thrombosis (DVT), arterial thrombosis or embolization, and early or recurrent bypass graft failure. The purpose of this study was to identify whether diabetes increased the likelihood of heparin-induced platelet factor 4 antibodies in at risk vascular patients. Methods. We reviewed clinical data on 300 consecutive patients. A hypercoagulable workup was performed if patients presented with (1) early bypass/graft thrombosis (<30 days), (2) multiple bypass/graft thrombosis, and (3) a history of DVT, pulmonary embolus (PE), or native vessel thrombosis. Relevant clinical variables were analyzed and compared between patients with diabetes (DM) and without diabetes (nDM). Results. 85 patients (47 women; age 53 16 years, range 16–82 years) had one of the defined conditions and underwent a hypercoagulable evaluation. Screening was done in 4.7% of patients with early bypass graft thrombosis, 60% of patients were screened because of multiple bypass or graft thrombosis, and 35.3% had a previous history of DVT, PE, or native vessel thrombosis. Of the 43 patients with DM and 42 nDM evaluated, 59 patients (69%) had an abnormal hypercoagulable profile. An elevated heparin antibody level was present in 30% of DM and 12% of nDM patients (chi-squared test ). Additionally, DM was associated with a higher likelihood of arterial complications while nDM was associated with a higher rate of venous adverse events (chi-squared test ). Conclusions. Diabetes is associated with a higher likelihood of developing heparin-induced antibodies and an increased combined incidence of arterial complications that include early or multiple bypass/graft thrombosis. This finding may influence the choice of anticoagulation in diabetic patients at risk with vascular disease. en_US
dc.language.iso en en_US
dc.title Elevated heparin-induced antibodies are more common in diabetic patients with vascular disease en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOP en_US
dc.author.idnumber 200201071 en_US
dc.author.department Pharmacy Practice en_US
dc.description.embargo N/A en_US
dc.relation.journal Thrombosis en_US
dc.journal.volume 2014 en_US
dc.identifier.doi http://dx.doi.org/10.1155/2014/649652 en_US
dc.identifier.ctation Naoum, J. J., Chamoun, N. R., Patel, M. S., Street, T. K., Haydar, M., Bismuth, J., ... & Peden, E. K. (2014). Elevated Heparin-Induced Antibodies Are More Common in Diabetic Patients with Vascular Disease. Thrombosis, 2014. en_US
dc.author.email nibal.chamoun@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://pubmed.ncbi.nlm.nih.gov/24672719/ en_US
dc.orcid.id https://orcid.org/0000-0002-0987-296X

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