The Challenge of Detecting Heparin-induced Thrombocytopenia (HIT) in a Developing Country: A Systematic Review.

Abstract

Introduction: Approximately 3% of patients treated with heparinoids develop heparin- induced thrombocytopenia (HIT). Although HIT is characterized by thrombocytopenia, type 2 HIT is associated with a high risk of thrombotic events in approximately 30-75% of cases. In some patients, thrombocytopenia represents the primary clinical manifestation of HIT. Early diagnosis of HIT is critical to prevent thrombotic complications by allowing timely replacement of heparin with an alternative anticoagulant. Clinical observations suggest a potential gap in the diagnosis and management of HIT among patients receiving heparinoid therapy in Iran.

Aim: hence, this study aimed to compile and analyze published data on the frequency and prevalence of HIT across various provinces in Iran, a representative developing country. The aim of this systematic review was to identify and highlight potential gaps in the diagnosis of HIT within different regions of the country.

Methods: To investigate this hypothesis, a systematic review was conducted to assess the prevalence of HIT and the adequacy of its detection in the country. Literature searches were performed using PubMed, Google Scholar, Web of Science, and local databases, yielding 81 articles. Following a rigorous evaluation, five studies met the inclusion criteria for the systematic review. The pooled analysis revealed an estimated HIT prevalence of 6.93% among the studied population. The mean age of participants ranged between 58 and 69 years, falling within the late-adolescent to early-elderly spectrum. The overall male-to-female ratio was 175:121 (59.2% male vs. 40.8% female).

Results: This study highlights a significant gap in the diagnosis of HIT in the country, suggesting that similar challenges may exist in other developing countries.

Conclusion: In conclusion, addressing this issue requires increased clinical awareness and improved diagnostic strategies to mitigate associated risks.