Research Topics
Species | T E WarkentinSummaryAffiliation: McMaster University Country: Canada Publications
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Publications
Bleeding risk and the management of bleeding complications in patients undergoing anticoagulant therapy: focus on new anticoagulant agentsMark A Crowther
Department of Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, USA
Blood 111:4871-9. 2008..Available data on the efficacy and safety of current and experimental agents for anticoagulant reversal are reviewed, and a plan for management of anticoagulant-induced bleeding is presented...
Delayed-onset HIT caused by low-molecular-weight heparin manifesting during fondaparinux prophylaxisKhalid A Alsaleh
Department of Medicine, Michael G DeGroote School of Medicine McMaster University, Hamilton, Ontario, Canada
Am J Hematol 83:876-8. 2008..Confirmed delayed-onset HIT with LMWH has not been previously reported. Low dose fondaparinux does not necessarily prevent thrombotic complications of HIT...
Anti-PF4/heparin antibodies and venous graft occlusion in postcoronary artery bypass surgery patients randomized to postoperative unfractionated heparin or fondaparinux thromboprophylaxisT E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
J Thromb Haemost 11:253-60. 2013..It is controversial whether non-platelet-activating antibodies are associated with thrombosis...
HITlights: a career perspective on heparin-induced thrombocytopeniaTheodore E Warkentin
Department of Pathology and Molecular Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
Am J Hematol 87:S92-9. 2012....
Differences in the clinically effective molar concentrations of four direct thrombin inhibitors explain their variable prothrombin time prolongationTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Thromb Haemost 94:958-64. 2005..DTIs with a relatively low affinity for thrombin require high plasma concentrations to double the APTT; these higher plasma concentrations, in turn, quench more of the thrombin generated in the PT, thereby more greatly prolonging the PT...
Laboratory testing for the antibodies that cause heparin-induced thrombocytopenia: how much class do we need?Theodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada Department of Medicine, McMaster University, Hamilton, Ontario, Canada
J Lab Clin Med 146:341-6. 2005..We conclude that an EIA that detects anti-PF4/polyanion antibodies of only the IgG class has greater diagnostic usefulness in revealing clinical HIT than does an assay that also detects IgA and IgM class antibodies...
Anti-platelet factor 4/heparin antibodies in orthopedic surgery patients receiving antithrombotic prophylaxis with fondaparinux or enoxaparinTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
Blood 106:3791-6. 2005..We conclude that despite similar immunogenicity of fondaparinux and LMWH, PF4/fondaparinux, but not PF4/LMWH, is recognized poorly by the antibodies generated, suggesting that the risk of HIT with fondaparinux likely is very low...
Bivalirudin: a reviewTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Expert Opin Pharmacother 6:1349-71. 2005..Anecdotal 'off-label' experience for the treatment of heparin-induced thrombocytopenia shows promise...
Heparin, low molecular weight heparin, and heparin-induced thrombocytopenia in the ICUTheodore E Warkentin
Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada
Crit Care Clin 21:513-29. 2005..This article describes clinical features of HIT and interpretation of laboratory tests for HIT antibodies from the perspective of the intensive care unit...
Heparin-induced skin lesions and other unusual sequelae of the heparin-induced thrombocytopenia syndrome: a nested cohort studyTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
Chest 127:1857-61. 2005....
New approaches to the diagnosis of heparin-induced thrombocytopeniaTheodore E Warkentin
Hamilton Regional Laboratory Medicine Program, Hamilton General Hospital, 237 Barton St E, Hamilton, ON L8L 2X2, Canada
Chest 127:35S-45S. 2005..By this approach, the magnitude of a positive test result determines its likelihood ratio in influencing the posttest probability of HIT...
Heparin-induced thrombocytopenia: diagnosis and managementTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Circulation 110:e454-8. 2004
Heparin-induced thrombocytopenia: recognition, treatment, and prevention: the Seventh ACCP Conference on Antithrombotic and Thrombolytic TherapyTheodore E Warkentin
Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, General Site, 237 Barton St E, Hamilton, Ontario L8L 2X2, Canada
Chest 126:311S-337S. 2004....
Heparin-induced thrombocytopenia and vascular surgeryT E Warkentin
Department of Pathology and Molecular Medicine, and Department of Medicine, McMaster University, and the Hamilton Regional Laboratory Medicine Program, Hamilton, Ontario, Canada
Acta Chir Belg 104:257-65. 2004..The transience of HIT antibodies provides a rationale for intraoperative use of heparin in a patient who has recovered from HIT and in whom HIT antibodies are no longer detectable...
An overview of the heparin-induced thrombocytopenia syndromeTheodore E Warkentin
Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
Semin Thromb Hemost 30:273-83. 2004..When using these agents, coumarin anticoagulation should be delayed pending substantial resolution of thrombocytopenia, before cautiously introducing overlapping coumarin therapy...
Bivalent direct thrombin inhibitors: hirudin and bivalirudinTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, and Hamilton Regional Laboratory Medicine Program, Hamilton General Site, Hamilton Health Sciences, Ont, Canada L8L 2X2
Best Pract Res Clin Haematol 17:105-25. 2004..Further work is required to define the scope of clinical thrombosis problems that could benefit from these novel agents...
Warfarin-associated multiple digital necrosis complicating heparin-induced thrombocytopenia and Raynaud's phenomenon after aortic valve replacement for adenocarcinoma-associated thrombotic endocarditisTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Am J Hematol 75:56-62. 2004....
HIT: lessons learnedTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Pathophysiol Haemost Thromb 35:50-7. 2006....
Gender imbalance and risk factor interactions in heparin-induced thrombocytopeniaTheodore E Warkentin
Department of Pathology, Hamilton Regional Laboratory Medicine Program, Rm 1 180A, Hamilton Health Sciences, Hamilton General Site, McMaster University, 237 Barton St E, Hamilton, ON L8L2X2 Canada
Blood 108:2937-41. 2006..93 vs 1.75; P = .005). We conclude that females are at greater risk for HIT and that using LMWH to prevent HIT may have greatest absolute benefit in females undergoing surgical thromboprophylaxis...
How I diagnose and manage HITTheodore E Warkentin
Department of Pathology and Molecular Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
Hematology Am Soc Hematol Educ Program 2011:143-9. 2011....
Heparin-induced thrombocytopenia in critically ill patientsTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
Crit Care Clin 27:805-23, v. 2011..A recent study showing that dalteparin is associated with a reduced frequency of HIT indicates that critically ill patients too can benefit from the HIT-reducing potential of this low molecular weight heparin preparation...
Fondaparinux: does it cause HIT? Can it treat HIT?Theodore E Warkentin
Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
Expert Rev Hematol 3:567-81. 2010..An emerging issue: will clinicians accept this favorable experience of fondaparinux for treating HIT when a lack of randomized trials will hinder regulatory approval for this indication?..
Agents for the treatment of heparin-induced thrombocytopeniaTheodore E Warkentin
Department of Pathology and Molecular Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
Hematol Oncol Clin North Am 24:755-75, ix. 2010....
Heparin-induced thrombocytopenia in patients with ventricular assist devices: are new prevention strategies required?Theodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Ann Thorac Surg 87:1633-40. 2009..Given the apparent high risk of HIT and its complications, and the diagnostic challenges, we suggest that the VAD patient population be evaluated using alternative, nonheparin agents for routine postimplantation anticoagulation...
Heparin-induced anaphylactic and anaphylactoid reactions: two distinct but overlapping syndromesTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton Health Sciences, General Site, Hamilton, Ontario, Canada
Expert Opin Drug Saf 8:129-44. 2009..However, heparin-induced anaphylactoid reactions also have been reported to be a consequence of immune-mediated heparin-induced thrombocytopenia (HIT)...
Studies of the immune response in heparin-induced thrombocytopeniaTheodore E Warkentin
Department of Pathology and Molecular Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
Blood 113:4963-9. 2009..Compared with seropositive non-HIT controls, HIT patients develop significantly higher anti-PF4/heparin IgG levels that are detectable before the onset of thrombocytopenia...
A spontaneous prothrombotic disorder resembling heparin-induced thrombocytopeniaTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Am J Med 121:632-6. 2008..We describe a novel syndrome, spontaneous heparin-induced thrombocytopenia, in which clinical and serologic features characteristic of this adverse drug reaction develop in patients despite the absence of preceding heparin therapy...
Treatment and prevention of heparin-induced thrombocytopenia: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition)Theodore E Warkentin
Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, 237 Barton Street E, Hamilton, Ontario, Canada
Chest 133:340S-380S. 2008..For patients receiving VKAs at the time of diagnosis of HIT, we recommend use of vitamin K (10 mg po or 5 to 10 mg IV) [Grade 1C]...
Quantitative interpretation of optical density measurements using PF4-dependent enzyme-immunoassaysT E Warkentin
Department of Pathology and Molecular Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
J Thromb Haemost 6:1304-12. 2008..An advantage of the EIA is its simplicity; a disadvantage is that it only indirectly detects heparin-dependent, platelet-activating antibodies ('HIT antibodies')...
BivalirudinTheodore E Warkentin
Department of Pathology and Molecular Medicine, Michael G DeGroote School of Medicine, McMaster Unniversity, Hamilton, Ontario, L8L 2X2 Canada
Thromb Haemost 99:830-9. 2008....
Heparin-induced thrombocytopeniaTheodore E Warkentin
Department of Pathology and Molecular Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
Hematol Oncol Clin North Am 21:589-607, v. 2007..Warfarin must be avoided or postponed, as the acute phase of HIT poses a high risk for coumarin necrosis, particularly limb loss due to venous limb gangrene...
PF4-dependent immunoassays and inferential detection of HIT antibodiesT E Warkentin
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
J Thromb Haemost 5:232-4. 2007
Heparin-induced thrombocytopenia and cardiac surgeryTheodore E Warkentin
Department of Pathology, McMaster University, Hamilton, Ontario, Canada
Ann Thorac Surg 76:2121-31. 2003..As heparin-induced thrombocytopenia antibodies are transient, unfractionated heparin alone is appropriate in a patient with previous heparin-induced thrombocytopenia whose antibodies have disappeared...
An improved definition of immune heparin-induced thrombocytopenia in postoperative orthopedic patientsTheodore E Warkentin
McMaster University, The Henderson Research Centre, and the Hamilton Regional Laboratory Medicine Program, Hamilton, Ontario, Canada
Arch Intern Med 163:2518-24. 2003..We sought to determine an improved definition of thrombocytopenia indicating HIT in postoperative orthopedic patients, including its impact on frequency and thrombotic risk of HIT...
Anti-PF4/heparin antibody formation postorthopedic surgery thromboprophylaxis: the role of non-drug risk factors and evidence for a stoichiometry-based model of immunizationT E Warkentin
Department of Pathology and Molecular Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
J Thromb Haemost 8:504-12. 2010..Heparin-induced thrombocytopenia is an antibody-mediated disorder exhibiting variable frequency in different clinical settings. Antibodies recognize PF4/heparin complexes formed at optimal stoichiometric molar ratios...
Heparin-induced thrombocytopenia: pathogenesis and managementTheodore E Warkentin
Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
Br J Haematol 121:535-55. 2003
Management of heparin-induced thrombocytopenia: a critical comparison of lepirudin and argatrobanTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Canada
Thromb Res 110:73-82. 2003..Thus, the DTI should be given alone during acute HIT, with oral anticoagulants deferred until substantial resolution of the thrombocytopenia has occurred...
Platelet count monitoring and laboratory testing for heparin-induced thrombocytopeniaTheodore E Warkentin
Department of Pathology and Molecular Medicine and the Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Arch Pathol Lab Med 126:1415-23. 2002..The objective of this article is to provide practical recommendations for platelet count monitoring in patients receiving heparin, as well as for selection of laboratory assays to detect pathogenic HIT antibodies...
Gastrointestinal bleeding, angiodysplasia, cardiovascular disease, and acquired von Willebrand syndromeTheodore E Warkentin
Department of Pathology, McMaster University, Hamilton, Ontario, Canada
Transfus Med Rev 17:272-86. 2003....
Laboratory diagnosis of immune heparin-induced thrombocytopeniaTheodore E Warkentin
Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton General Site, 237 Baron Street East, Hamilton, ON L8L 2X2, Canada
Curr Hematol Rep 2:148-57. 2003..quot; However, optimal diagnostic information requires that laboratory test results be interpreted in the appropriate clinical context...
Heparin-induced thrombocytopenia and cardiac surgeryTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Ann Thorac Surg 76:638-48. 2003..As heparin-induced thrombocytopenia antibodies are transient, unfractionated heparin alone is appropriate in a patient with previous heparin-induced thrombocytopenia whose antibodies have disappeared...
Impact of the patient population on the risk for heparin-induced thrombocytopeniaT E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Blood 96:1703-8. 2000..HIT-IgG antibodies are more likely to form in patients who undergo cardiac surgery than in orthopedic patients, but among patients in whom antibodies do form, orthopedic patients are more likely to develop HIT. (Blood. 2000;96:1703-1708)..
Multicentric warfarin-induced skin necrosis complicating heparin-induced thrombocytopeniaT E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Am J Hematol 62:44-8. 1999..Neither patient had an identifiable hypercoagulable syndrome, other than HIT. HIT may represent a risk factor for the development of multicentric warfarin-induced skin necrosis (WISN)...
Delayed-onset heparin-induced thrombocytopenia and thrombosisT E Warkentin
Hamilton Regional Laboratory Medicine Program, Hamilton General Hospital, Hamilton Health Sciences, 237 Barton Street East, Hamilton, Ontario L8L 2X2, Canada
Ann Intern Med 135:502-6. 2001..This syndrome could be caused by high titers of platelet-activating IgG induced by heparin...
Venous thromboembolism in heparin-induced thrombocytopeniaT E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Curr Opin Pulm Med 6:343-51. 2000....
Limitations of conventional treatment options for heparin-induced thrombocytopeniaT E Warkentin
Department of Pathology, McMaster University, Hamilton, Ontario, Canada
Semin Hematol 35:17-25; discussion 35-6. 1998..Moreover, clinically significant cross-reactivity during treatment with danaparoid appears to be uncommon, even in patients in whom in vitro cross-reactivity is demonstrable...
Fondaparinux treatment of acute heparin-induced thrombocytopenia confirmed by the serotonin-release assay: a 30-month, 16-patient case seriesT E Warkentin
Departments of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
J Thromb Haemost 9:2389-96. 2011..Although reports of the use of fondaparinux for this indication have thus far been favorable, the diagnosis of HIT in most cases was not based on definitive laboratory confirmation of heparin-dependent, platelet-activating antibodies...
Rapid anticoagulation using ancrod for heparin-induced thrombocytopeniaC Demers
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Blood 78:2194-7. 1991..No other side effects were noted. Our experience indicates that ancrod therapy is a reasonable approach for patients with heparin-induced thrombocytopenia who require anticoagulant therapy...
Temporal aspects of heparin-induced thrombocytopeniaT E Warkentin
Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences Corporation, Ont, Canada
N Engl J Med 344:1286-92. 2001..CONCLUSIONS: Heparin-induced thrombocytopenia can begin rapidly in patients who have received heparin within the previous 100 days. Heparin-dependent antibodies do not invariably reappear with subsequent heparin use...
Central venous catheters and upper-extremity deep-vein thrombosis complicating immune heparin-induced thrombocytopeniaAaron P Hong
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
Blood 101:3049-51. 2003..0; P =.011). We conclude that a localizing vascular injury (CVC use) and a systemic hypercoagulability disorder (HIT) interact to explain upper-extremity DVT complicating HIT...
Cardiobacterium hominis endocarditis associated with very severe thrombocytopenia and platelet autoantibodiesDonald M Arnold
Department of Hematology, McMaster University, Hamilton, Ontario, Canada
Am J Hematol 76:373-7. 2004..This report illustrates that the development of platelet autoantibodies can contribute to very severe thrombocytopenia in occasional patients with infective endocarditis...
Multimerin is found in the alpha-granules of resting platelets and is synthesized by a megakaryocytic cell lineC P Hayward
Department of Medicine, McMaster University Medical Centre, Hamilton, Canada
J Clin Invest 91:2630-9. 1993..Biosynthesis of multimerin by a megakaryocytic cell line supports endogenous biosynthesis by megakaryocytes as the origin of this platelet alpha-granule protein...
Evaluation of pretest clinical score (4 T's) for the diagnosis of heparin-induced thrombocytopenia in two clinical settingsG K Lo
Department of Medicine, McMaster University, Hamilton, ON, Canada
J Thromb Haemost 4:759-65. 2006..CONCLUSIONS: A low pretest clinical score for HIT seems to be suitable for ruling out HIT in most situations (high-negative predictive value). The implications of an intermediate or high score vary in different clinical settings...
Venous limb gangrene during warfarin treatment of cancer-associated deep venous thrombosisT E Warkentin
McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
Ann Intern Med 135:589-93. 2001..CONCLUSION: Warfarin may contribute to the pathogenesis of cancer-associated venous limb gangrene by leading to severe depletion of protein C while at the same time failing to reduce thrombin generation...
Decreased von Willebrand factor protease activity associated with thrombocytopenic disordersJ C Moore
Department of Medicine, Faculty of Health Science, McMaster University, Hamilton, ON, Canada
Blood 98:1842-6. 2001..This study indicates that abnormalities of vWF protease activity are not restricted to patients with the diagnosis of TTP...
The IgG subclasses of platelet-associated autoantibodies directed against platelet glycoproteins IIb/IIIa in patients with idiopathic thrombocytopenic purpuraHoward Chan
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Br J Haematol 122:818-24. 2003..Our results are consistent with the hypothesis that ITP is a heterogeneous disorder and that some patients have evidence of oligoclonality, whereas other patients have polyclonal autoantibodies...
A systematic evaluation of laboratory testing for drug-induced immune thrombocytopeniaD M Arnold
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
J Thromb Haemost 11:169-76. 2013..Drug-induced immune thrombocytopenia (DITP) can be confirmed by the demonstration of drug-dependent platelet antibodies in vitro; however, laboratory testing is not readily accessible and test methods are not standardized...
HIT paradigms and paradoxesT E Warkentin
Department of Pathology and Molecular Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
J Thromb Haemost 9:105-17. 2011....
Off-pump coronary artery bypass grafting for acute heparin-induced thrombocytopeniaT E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Ann Thorac Surg 72:1730-2. 2001....
Heparin-induced thrombocytopenia: a historical perspectiveJohn G Kelton
Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
Blood 112:2607-16. 2008
Heparin-induced thrombocytopenia and the anesthesiologistTheodore E Warkentin
Department of Pathology and Molecular Medicine, Department of Medicine, McMaster University, Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
Can J Anaesth 49:S36-49. 2002..CONCLUSION: HIT is an infrequent but important topic for anesthesiologists because of the urgency and complexity of the various associated management issues...
What is the potential for overdiagnosis of heparin-induced thrombocytopenia?Gregory K Lo
Department of Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
Am J Hematol 82:1037-43. 2007..20 OD units). We conclude there is the potential to overdiagnose HIT by approximately 100% if any positive EIA is considered to "confirm" the diagnosis of HIT irrespective of the clinical scenario...
Should aspirin be discontinued before coronary artery bypass surgery?Jack C J Sun
Division of Cardiac Surgery, McMaster University, Hamilton, Canada
Circulation 112:e85-90. 2005
The 4Ts scoring system for heparin-induced thrombocytopenia in medical-surgical intensive care unit patientsMark Andrew Crowther
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
J Crit Care 25:287-93. 2010..The 4Ts score (Thrombocytopenia, Timing of thrombocytopenia, Thrombosis, and oTher reason) might identify individual patients at risk of having this disorder...
Current agents for the treatment of patients with heparin-induced thrombocytopeniaTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Curr Opin Pulm Med 8:405-12. 2002....
Drug-induced immune-mediated thrombocytopenia--from purpura to thrombosisTheodore E Warkentin
Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
N Engl J Med 356:891-3. 2007
Combination immunosuppressant therapy for patients with chronic refractory immune thrombocytopenic purpuraDonald M Arnold
Department of Medicine, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
Blood 115:29-31. 2010..Severe adverse events did not occur. Combination immunosuppressant therapy can produce a rise in the platelet count that is sometimes sustained in refractory ITP patients...
Testing for heparin-induced thrombocytopenia antibodiesTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Ontario, Canada
Transfus Med Rev 20:259-72. 2006..Whether such antibodies impart "forme fruste" HIT or are simply a surrogate marker for a non-HIT adverse risk factor such as inflammation is unresolved...
Reversing anticoagulants both old and newTheodore E Warkentin
Department of Pathology and Molecular Medicine, McMaster University, Hamilton Regional Laboratory Medicine Program, Hamilton Health Sciences, Hamilton, Ontario, Canada
Can J Anaesth 49:S11-25. 2002..CONCLUSION: Newer anticoagulant agents generally lack specific antidotes. Thus, careful choice of an anticoagulant agent and laboratory monitoring where appropriate are needed to minimize risk of bleeding complications...
Warfarin cessation before cardiopulmonary bypass: lessons learned from a randomized controlled trial of oral vitamin KRichard P Whitlock
Division of Cardiac Surgery, HHSC, McMaster University, Hamilton, Ontario, Canada
Ann Thorac Surg 84:103-8. 2007..Administration of preoperative oral vitamin K was investigated in a randomized, placebo-controlled trial. A post hoc analysis examined residual anti-Xa activity of enoxaparin bridging...
Heparin-induced thrombocytopeniaTheodore E Warkentin
Hamilton General Hospital, 237 Barton St. East, Hamilton, Ontario L8L 2X2, Canada
Curr Hematol Rep 1:63-72. 2002..Recent reports suggest that HIT could explain approximately 5% of cases of acute adrenal failure caused by bilateral adrenal hemorrhagic infarction...
Prothrombotic genetic risk factors and heparin-induced thrombocytopeniaTheodore E Warkentin
Department of Pathology and Molecualr Medicine, McMaster University, Hamilton, Ontario, Canada
Pharmacogenetics 13:245-6. 2003
A prospective study measuring the development of antibodies against platelet factor 4-heparin in healthy males after exposure to heparinsJ G Kelton
Michael G DeGroote School of Medicine, Departments of Medicine, Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada Division of Hematology, Duke University Medical Center, Durham, NC, USA Momenta Pharmaceutics, Cambridge, MA, USA
J Thromb Haemost 10:1446-9. 2012..A prospective study measuring the development of antibodies against platelet factor 4-heparin in healthy males after exposure to heparins. J Thromb Haemost 2012; 10: 1446-9...
Managing bleeding in anticoagulated patients with a focus on novel therapeutic agentsM A Crowther
Division of Hematology, Department of Medicine, McMaster University, Hamilton, ON, Canada
J Thromb Haemost 7:107-10. 2009..However, these new agents have one general limitation--a lack of a widely available antidote. We focus on the management of bleeding in anticoagulated patients, with particular regard to novel anticoagulants...
The approach to heparin-induced thrombocytopeniaLori Ann Linkins
Department of Medicine, McMaster University, Hamilton, Ontario, Canada
Semin Respir Crit Care Med 29:66-74. 2008....
Thrombocytopenia in medical-surgical critically ill patients: prevalence, incidence, and risk factorsMark A Crowther
Department of Medicine and Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada L8N 3Z5
J Crit Care 20:348-53. 2005..Heparin-induced thrombocytopenia was frequently suspected but did not develop in these critically ill patients...
Gova/b alloantigen system on human plateletsJ G Kelton
Department of Medicine, McMaster Medical Centre, Hamilton, Ontario, Canada
Blood 75:2172-6. 1990..The phenotypic frequencies were Gova/Gova, 26%; Gova/Govb, 55%; Govb/Govb, 19%; giving gene frequencies of 0.532 and 0.468 for Gova and Govb, respectively (n = 33)...
Case report: management of immediate post-cardiopulmonary bypass massive intra-cardiac thrombosisVictor M Neira
Department of Anesthesia HSC 2U1, McMaster University, 1200 Main Street West, Hamilton, Ontario L8N 3Z5, Canada
Can J Anaesth 54:461-6. 2007..To describe the management of severe acute intracardiac thrombosis in a patient who underwent redo multiple valve replacement and valvular repair. The diagnostic features, associated risk factors, and anesthetic management are reviewed...
Analysis of a nonsusceptible fraction with current status dataRichard J Cook
Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada
Stat Med 27:2715-30. 2008..The methods are applied to motivating studies examining an immunological response to low molecular weight heparin in patients undergoing orthopedic surgery...
Hypotensive transfusion reactions can occur with blood products that are leukoreduced before storageDonald M Arnold
Canadian Blood Services, Ontario, Canada
Transfusion 44:1361-6. 2004..CONCLUSION: Hypotensive reactions can occur with blood products that are LR before storage and non-LR ANH. An inherent defect in the metabolism of kinins may be a risk factor for the development of hypotensive transfusion reactions...
Posttransfusion platelet count increments after ABO-compatible versus ABO-incompatible platelet transfusions in noncancer patients: an observational studyKaterina Pavenski
Department of Medicine, McMaster University, and Canadian Blood Services, Hamilton, Ontario, Canada
Transfusion 50:1552-60. 2010..However, most studies to date have been small and involved hematology/oncology patients...
Transfusion premedication to prevent acute transfusion reactions: a retrospective observational study to assess current practicesJessica L Fry
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Transfusion 50:1722-30. 2010....
Anticoagulation for cardiopulmonary bypass: is a replacement for heparin on the horizon?Theodore E Warkentin
J Thorac Cardiovasc Surg 131:515-6. 2006
Immune heparin-induced thrombocytopenia can occur in patients receiving clopidogrel and aspirinKathleen Selleng
Institute of Immunology and Transfusion Medicine, Ernst-Moritz-Arndt University, Greifswald, Germany
Am J Hematol 78:188-92. 2005..We conclude that combined therapy with aspirin and clopidogrel does not necessarily protect against clinical HIT, at least in patients with HIT antibodies that have strong platelet-activating characteristics...
Who is (still) getting HIT?Theodore E Warkentin
Chest 131:1620-2. 2007
Comment: treatment of heparin-induced thrombocytopeniaMaureen A Smythe
Ann Pharmacother 36:1483-4; author reply 1484. 2002
Heparin-induced thrombocytopeniaTheodore E Warkentin
Dis Mon 51:141-9. 2005
Recognition, treatment, and prevention of heparin-induced thrombocytopenia: review and updateAndreas Greinacher
Ernst Moritz Arndt Univerität Greifswald, Institut für Immunologie und Transfusionsmedizin, Germany
Thromb Res 118:165-76. 2006....
Pork or beef?Theodore E Warkentin
Ann Thorac Surg 75:15-6. 2003
Thrombosis of the cerebral veins and sinusesTheodore E Warkentin
N Engl J Med 353:314-5. 2005
Gastrointestinal angiodysplasia and aortic stenosisTheodore E Warkentin
N Engl J Med 347:858-9. 2002
Think of HIT when thrombosis follows heparinTheodore E Warkentin
Chest 130:631-2. 2006
Heparin-induced thrombocytopenia in the critical care setting: diagnosis and managementLena M Napolitano
Acute Care Surgery, Trauma, Burn, Critical Care, Emergency Surgery, Department of Surgery, University of Michigan Health System, Ann Arbor, MI, USA
Crit Care Med 34:2898-911. 2006..g., argatroban or lepirudin) or the heparinoid danaparoid (where available) reduces the risk of thromboembolic events, some of which may be life-threatening...
Venous limb gangrene during overlapping therapy with warfarin and a direct thrombin inhibitor for immune heparin-induced thrombocytopeniaMaureen A Smythe
Department of Pharmaceutical Services, William Beaumont Hospital, Royal Oak, Michigan 48073-6769, USA
Am J Hematol 71:50-2. 2002..These data suggest that warfarin anticoagulation be postponed in patients with acute heparin-induced thrombocytopenia until substantial recovery of the platelet count has occurred...
Minimizing costs for treating deep vein thrombosis: the role for fondaparinuxAndrew F Shorr
Pulmonary and Critical Care Medicine, Washington Hospital Center, 110 Irving St, NW, Washington, DC 20010, USA
J Thromb Thrombolysis 23:229-36. 2007....
Heparin-induced thrombocytopenia in intensive care patientsKathleen Selleng
Department of Immunology and Transfusion Medicine, Ernst Moritz Arndt Universitat, Greifswald, Germany
Crit Care Med 35:1165-76. 2007....
Delayed-onset heparin-induced thrombocytopenia and cerebral thrombosis after a single administration of unfractionated heparinTheodore E Warkentin
N Engl J Med 348:1067-9. 2003
So, does low-molecular-weight heparin cause less heparin-induced thrombocytopenia than unfractionated heparin or not?Theodore E Warkentin
Chest 132:1108-10. 2007
Laboratory testing for heparin-induced thrombocytopenia is inconsistent in North America: a survey of North American specialized coagulation laboratoriesElizabeth A Price
Department of Medicine, Stanford University, Stanford, California, USA
Thromb Haemost 98:1357-61. 2007..The variability in HIT platelet activation assay methods among institutions indicates a need for proficiency testing to assess assay performance, and for consensus guidelines on HIT laboratory testing...
Fondaparinux versus direct thrombin inhibitor therapy for the management of heparin-induced thrombocytopenia (HIT)--bridging the River CoumarinTheodore E Warkentin
Thromb Haemost 99:2-3. 2008
Close approximation of two platelet factor 4 tetramers by charge neutralization forms the antigens recognized by HIT antibodiesAndreas Greinacher
Institute for Immunology and Transfusion Medicine, Ernst Moritz Arndt University, Sauerbruchstrasse, 17489 Greifswald, Germany
Arterioscler Thromb Vasc Biol 26:2386-93. 2006..To better understand these findings, we analyzed the molecular structure of the complexes formed between PF4 and UFH, LMWH, or fondaparinux...
