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COMMENTS AND OPINIONS
Risk Factors for Thrombocytopenia in Patients Treated With Prolonged Heparin Therapy
David R. Williamson, BPharm, MSc, BCPS;
Danielle Pilon, MD, MSc
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We read with great interest the recent study by Oliveira et al.1 This study reported a high risk of thrombocytopenia in a group of patients receiving heparin therapy, with very few cases caused by heparin-induced thrombocytopenia. These results highlight the high prevalence and incidence rates reported in many intensive care unit–based studies.2-4 The study also reported a strikingly important association between thrombocytopenia and risk of death. This observation also corroborates a previously reported association.2-4
In a logistic regression analysis, Oliveira et al1 identified cardiac and vascular surgery, baseline platelet counts, intravenous heparin, admission for an acute coronary syndrome, and coadministration of heparin and a low-molecular-weight heparin as independent risk factors for thrombocytopenia. Although the results of this analysis are interesting, we have several concerns regarding indication bias as well as confounding, which may limit the interpretation of this data.
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RELATED LETTER
Risk Factors for Thrombocytopenia in Patients Treated With Prolonged Heparin Therapy—Reply
Christopher B. Granger, E. Magnus Ohman, and Richard C. Becker
Arch Intern Med. 2008;168(19):2171.
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