Heparin-Induced Thrombocytopenia and Cardiac Surgery

Semin Thorac Cardiovasc Surg. 2019;31(3):335-344. doi: 10.1053/j.semtcvs.2018.10.011. Epub 2018 Nov 15.


Heparin-induced thrombocytopenia (HIT) is an immune-mediated condition characterized by thrombocytopenia with possible arterial and/or venous thrombosis. The overall incidence of HIT is low but ranges from 0.1% to 5%.1,2 The incidence can be as high as 3% in patients undergoing cardiac surgery. The use of unfractionated heparin (UFH) is ubiquitous in patients who undergo cardiac procedures and carries a 10-fold higher incidence of HIT over low molecular weight heparin. Patients undergoing cardiac surgery thus form a unique group that warrants specific attention to this clinicopathologic entity considering the relatively high incidence and associated morbidity and mortality with a delay in diagnosis. In this article, we will discuss 5 clinical aspects pertinent to the diagnosis and management of HIT in cardiac surgery patients and review the current literature.

Keywords: Cardiac surgery; HIT; Heparin induced thrombocytopenia.

Publication types

  • Review

MeSH terms

  • Antibodies / blood
  • Anticoagulants / adverse effects*
  • Anticoagulants / immunology
  • Biomarkers / blood
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiac Surgical Procedures / mortality
  • Heparin / adverse effects*
  • Heparin / immunology
  • Humans
  • Incidence
  • Platelet Factor 4 / immunology
  • Prognosis
  • Risk Factors
  • Thrombocytopenia / chemically induced*
  • Thrombocytopenia / immunology
  • Thrombocytopenia / mortality
  • Thrombocytopenia / therapy


  • Antibodies
  • Anticoagulants
  • Biomarkers
  • PF4 protein, human
  • Platelet Factor 4
  • Heparin