Thromb Haemost 2020; 120(07): 1096-1107
DOI: 10.1055/s-0040-1712957
Cellular Haemostasis and Platelets
Georg Thieme Verlag KG Stuttgart · New York

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

Yves Gruel
1   EA 7501, GICC, Université de Tours, Tours, France
2   Service d'Hématologie-Hémostase, CHRU Tours, Tours, France
Caroline Vayne
1   EA 7501, GICC, Université de Tours, Tours, France
2   Service d'Hématologie-Hémostase, CHRU Tours, Tours, France
Jérôme Rollin
1   EA 7501, GICC, Université de Tours, Tours, France
2   Service d'Hématologie-Hémostase, CHRU Tours, Tours, France
Pierre Weber
2   Service d'Hématologie-Hémostase, CHRU Tours, Tours, France
Dorothée Faille
3   Laboratoire d'Hématologie, Hôpital Bichat, Paris, France
Anne Bauters
4   Département d'Hémostase et Transfusion, CHU Lille, Lille, France
Laurent Macchi
5   Laboratoire d'Hématologie, CHRU Angers, Angers, France
Martine Alhenc-Gelas
6   Laboratoire d'Hématologie, HEGP Paris, Paris, France
7   Laboratoire d'Hématologie, CHRU Clermont-Ferrand, Clermont-Ferrand, France
Emmanuel De Maistre
8   Laboratoire d'Hématologie, CHRU Dijon, Dijon, France
Sophie Voisin
9   Laboratoire d'Hématologie, CHRU Toulouse, Toulouse, France
Valérie Gouilleux-Gruart
1   EA 7501, GICC, Université de Tours, Tours, France
10   Laboratoire d'Immunologie, CHRU Tours, Tours, France
Julien Perrin
11   Laboratoire d'Hématologie, CHRU Nancy, Nancy, France
Brigitte Tardy-Poncet
12   Laboratoire d'Hématologie, CHRU Saint-Etienne, Saint-Etienne, France
Ismail Elalamy
13   Laboratoire d'Hématologie, Hôpital Tenon, Paris, France
Cécile Lavenu-Bombled
14   Laboratoire d'Hématologie, Hôpital Henri Mondor, Créteil, France
Christine Mouton
15   Laboratoire d'Hématologie, CHRU Bordeaux, Bordeaux, France
Christine Biron
16   Laboratoire d'Hématologie, CHRU Montpellier, Montpellier, France
Catherine Ternisien
17   Laboratoire d'Hématologie, CHRU Nantes, Nantes, France
Fabienne Nedelec-Gac
18   Laboratoire d'Hématologie, CHRU Rennes, Rennes, France
Jérôme Duchemin
19   Laboratoire d'Hématologie, CHRU Poitiers, Poitiers, France
Emmanuelle De Raucourt
20   Laboratoire d'Hématologie, Hopital Beaujon, Clichy, France
Isabelle Gouin-Thibault
21   Laboratoire d'Hématologie, Hopital Cochin, Paris, France
Lucia Rugeri
22   Laboratoire d'Hématologie, CHRU Lyon, Lyon, France
Bernard Tardy
23   INSERM CIC 1408, Unité de soins intensifs, CHRU Saint-Etienne, Saint-Etienne, France
Bruno Giraudeau
24   INSERM CIC, CHRU Tours, Tours, France
Théodora Bejan-Angoulvant
1   EA 7501, GICC, Université de Tours, Tours, France
25   Département de Pharmacologie Médicale, CHRU Tours, Tours, France
Claire Pouplard
1   EA 7501, GICC, Université de Tours, Tours, France
2   Service d'Hématologie-Hémostase, CHRU Tours, Tours, France
› Author Affiliations
Funding The project FRIGTIH was supported by a PHRC grant (PHRN09-YG/FRIGTIH) and by the IRTH (Institut pour la Recherche sur la Thrombose et l'Hémostase).
Further Information

Publication History

09 January 2020

23 April 2020

Publication Date:
22 June 2020 (online)


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.

Authors' Contributions

Y.G. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Y.G., B.G., and C.P. designed the research, C.V., J.R., and P.V. performed the research, Y.G., D.F., A.B., L.A., M.A.G., A.L., E.D.M., S.V., B.T., B.T.P., J.P., I.E., S.D., C.L.B., C.M., M.W., C.B., C.T., F.N., P.G., J.D., L.R., E.D.R., I.G.T., and C.P. provided patients samples and clinical follow-up. Y.G., C.V., J.R., P.V., B.G., T.B.A., and C.P. analyzed the data. Y.G. and C.P. supervised the study and wrote the paper.

Supplementary Material

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