Heparin antibodies may pose risk in heart surgery patients

WINSTON-SALEM, N.C. New research suggests that patients who develop antibodies to the anti-clotting drug heparin nearly double their risk of death or serious complication after heart surgery.

"Complications after heart surgery are typically attributed to the surgery alone," said Thomas Slaughter, M.D., co-principal investigator on the project and a professor of anesthesiology at Wake Forest University Baptist Medical Center. "Our study examined whether development of heparin antibodies before surgery poses an independent risk."

The study, which involved 466 patients scheduled to undergo either coronary artery bypass or valve replacement surgery, is reported in this month's Journal of Thoracic and Cardiovascular Surgery. Conducted by investigators at Wake Forest University Baptist and Duke University medical centers, it is the first study to convincingly demonstrate a relationship between heparin antibodies and complications after cardiac surgery.

Heparin is administered intravenously during many procedures, including kidney dialysis, heart catheterization or angioplasty, as well as during heart and vascular surgeries. Estimates suggest that nearly half of patients treated with heparin develop the antibodies, which may last for months.

The researchers theorize that in patients with heparin antibodies, subsequent treatment with heparin activates blood components that cause clotting and inflammation, increasing the risk for heart attacks, heart rhythm problems, strokes and other complications.

"While it is too early to recommend universal testing for the antibodies, our study is the most definitive evidence to date that heparin antibodies increase the risk for death and complications associated with cardiac surgery," said Slaughter.

The researchers tested heparin antibody levels in all study patients before surgery. They found that patients with the antibodies experienced a nearly twofold greater risk of death or hospi

Contact: Karen Richardson
Wake Forest University Baptist Medical Center

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