dc.contributor.author | Hernandez, Jessica | |
dc.contributor.author | Patel, Hetal | |
dc.contributor.author | Biddlecome, Phil | |
dc.contributor.author | Kildea, Megan | |
dc.contributor.author | Dwivedi, Ruti | |
dc.contributor.author | Sridhara, Shashank | |
dc.contributor.author | Silvestry, Scott | |
dc.contributor.author | Cavarocchi, Nicholas | |
dc.contributor.author | Francis, John L. | |
dc.contributor.author | Ventura, Davide | |
dc.date.accessioned | 2023-05-31T15:08:30Z | |
dc.date.available | 2023-05-31T15:08:30Z | |
dc.date.issued | 2023-04-17 | |
dc.identifier.citation | Hernandez J, Patel H, Biddlecome P, et al. Evaluation of Latex Immunoturbidimetric Assay Thresholds and HIT in Cardiothoracic Surgery. Clinical and Applied Thrombosis/Hemostasis. 2023;29. doi: 10.1177/10760296231166370 | en_US |
dc.identifier.uri | https://hdl.handle.net/1808/34244 | |
dc.description.abstract | Background
Heparin-induced thrombocytopenia (HIT) is a common differential diagnosis in cardiothoracic surgery. The latex immunoturbidimetric assay (LIA) is an enhanced immunoassay that has recently been introduced for the detection of total HIT immunoglobulin and retains a higher specificity of 95% compared to the enzyme-linked immunosorbent assay.
Objectives
To investigate if a semiquantitative relationship exists between increasing LIA levels beyond the current positivity threshold and its correlation to positive serotonin release assay results in cardiothoracic surgery.
Methods
This was a multicenter, observational cohort of cardiothoracic surgery patients initiated on anticoagulation with heparin-based products. To conduct sensitivity and specificity analysis of LIA values, HIT positive was defined as a LIA value ≥1 unit/mL and HIT negative was defined as a LIA level <1 unit/mL. A receiver operating characteristic (ROC) analysis was utilized to evaluate the predictive performance of the LIA.
Results
At manufactures’ cutoffs of ≥1.0 unit/mL, LIA sensitivity and specificity was 93.8% and 22%, respectively, yielding a false positive rate of 78%. At a higher cutoff of 4.5 units/mL, LIA sensitivity and specificity was 75% and 71%, respectively, yielding a false positive rate of 29% and an area under the ROC curve of 0.75 (P = .01; 95% confidence interval: 0.621-0.889). Bivalirudin was initiated in 84.6% of false positive LIA results.
Conclusion
This study suggests that the diagnostic accuracy of the LIA can be optimized by increasing the LIA positivity threshold. Proposing a higher LIA cutoff, may mitigate unwarranted anticoagulation and bleeding outcomes. | en_US |
dc.publisher | SAGE Publications | en_US |
dc.rights | © The Author(s) 2023. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License. | en_US |
dc.rights.uri | https://creativecommons.org/licenses/by-nc/4.0/ | en_US |
dc.subject | Heparin-induced thrombocytopenia | en_US |
dc.subject | Immunology | en_US |
dc.subject | Cardiac surgery | en_US |
dc.subject | Bioassay | en_US |
dc.title | Evaluation of Latex Immunoturbidimetric Assay Thresholds and HIT in Cardiothoracic Surgery | en_US |
dc.type | Article | en_US |
kusw.kuauthor | Hernandez, Jessica | |
kusw.kuauthor | Ventura, Davide | |
kusw.kudepartment | Pharmacy | en_US |
dc.identifier.doi | 10.1177/10760296231166370 | en_US |
dc.identifier.orcid | https://orcid.org/0000-0002-2378-2792 | en_US |
kusw.oaversion | Scholarly/refereed, publisher version | en_US |
kusw.oapolicy | This item meets KU Open Access policy criteria. | en_US |
dc.identifier.pmid | PMC10123911 | en_US |
dc.rights.accessrights | openAccess | en_US |