Heparin Resistance

Difficulty in maintaining therapeutic anticoagulation despite increasing heparin dosage, or heparin resistance, is a common finding in patients with HIT-associated thrombosis (Rhodes et al., 1977; Silver et al., 1983). Possible explanations include neutralization of heparin by PF4 released from activated platelets (Padilla et al., 1992) or pathophysiological consequences of platelet-derived microparticles (Bode et al., 1991). Heparin resistance is not specific for HIT, however, and occurs in many patients with extensive thrombosis of various etiologies (e.g., cancer).

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