Optimization of laboratory diagnosis of heparin-induced thrombocytopenia using HemosIL-AcuStar-HIT-IgG assay.

Laboratory medicine Pub Date : 2024-01-06 DOI:10.1093/labmed/lmad029

Catherine M Tucker, Ruben Rhoades, Ruchika Sharma, Jerald Z Gong

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Abstract

Objective: The aim of this study was to determine an optimal cutoff value for the newly available HemosIL-AcuStar-HIT-IgG assay (AcuStar) for the diagnosis of heparin-induced thrombocytopenia (HIT).

Method: We evaluated the performance of AcuStar using serotonin release assay (SRA) as the gold standard and incorporated 4T score calculation in a cohort of suspected HIT cases. Statistical analysis was performed to determine optimal cutoff value for the diagnosis of HIT.

Result: A diagnosis of HIT can be excluded with a platelet factor 4 (PF4) value of <0.4 U/mL by AcuStar and 4T score in the low-risk category (≤3). All other cases will require confirmation with a functional test.

Conclusion: Our study resulted in the implementation of a diagnostic algorithm for laboratory diagnosis of HIT, which incorporates pretest calculation of 4T score and AcuStar as a screening test, with reflex confirmation by SRA. This new algorithm resulted in extended hours of test availability and a more rapid turnaround time in reporting PF4 results.

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使用 HemosIL-AcuStar-HIT-IgG 检测法优化肝素诱导的血小板减少症的实验室诊断。

研究目的本研究旨在确定新上市的HemosIL-AcuStar-HIT-IgG测定（AcuStar）诊断肝素诱导血小板减少症（HIT）的最佳临界值：方法：我们以血清素释放测定（SRA）为金标准评估了AcuStar的性能，并在一组疑似HIT病例中纳入了4T评分计算。通过统计分析确定了诊断 HIT 的最佳临界值：结果：血小板因子 4（PF4）值为 0 时可排除 HIT 诊断：根据我们的研究结果，实验室诊断 HIT 的诊断算法得以实施，该算法结合了 4T 评分和 AcuStar 作为筛查试验的检验前计算，并通过 SRA 进行反射性确认。这种新算法延长了检测时间，加快了报告 PF4 结果的周转时间。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Laboratory medicine

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