{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T07:00:04Z","timestamp":1790406004653,"version":"4.1.0"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"06","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2013]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>A new ELISA (Zymutest HIA\u00ae), based on incubation of diluted plasma with protamine\/heparin (PRT\/H) complexes without and with platelet factor 4 (PF4) provided by a platelet lysate, was used to detect heparindependent antibodies in a cohort of 232 cardiac surgery (CS) patients and in 47 patients with heparin-induced thrombocytopenia (HIT). Significant binding of IgG\/A\/M to PRT\/H complexes was demonstrated in 59 CS patients (25.4%), with similar absorbances whether platelet lysate was added to the plasma or not, and significant reactivity to PF4\/H in 29 of them. Antibodies to PRT or heparin alone were present in 15 and two of these patients, respectively. Importantly, antibodies to PRT\/H were detected in only three of the 47 HIT patients, who had also undergone recent CS. The Zymutest HIA\u00ae was positive in another 41 CS patients (17%), but only or mainly when their plasma was tested with platelet lysate, with significant levels of antibodies to PF4\/H in 40 of them without detectable reactivity to PRT or heparin alone. Slight antibody binding to PRT\/H complexes was also measured in six of these 41 patients. Therefore, a total of 35 CS patients exhibited dual antibody reactivity towards PRT\/H and PF4\/H complexes. Serotonin release assay performed with PRT alone was positive in 17 CS patients with antibodies to PRT\/H, but all had normal platelet count evolution without thrombosis postoperatively. In conclusion, antibodies to PRT\/H are frequently present in CS patients postoperatively (25.4%), and can activate platelets in vitro, but their clinical impact remains questionable.<\/jats:p>","DOI":"10.1160\/th12-11-0844","type":"journal-article","created":{"date-parts":[[2013,5,2]],"date-time":"2013-05-02T18:06:04Z","timestamp":1367517964000},"page":"1141-1147","source":"Crossref","is-referenced-by-count":21,"title":["Incidence of antibodies to protamine sulfate\/heparin complexes in cardiac surgery patients and impact on platelet activation and clinical outcome"],"prefix":"10.1160","volume":"109","author":[{"given":"Doroth\u00e9e","family":"Leroux","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00e9rome","family":"Rollin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Amiral","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc-Antoine","family":"May","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Pouplard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yves","family":"Gruel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2017,12,15]]},"reference":[{"key":"10.1160\/TH12-11-0844-1","doi-asserted-by":"crossref","first-page":"1703","DOI":"10.1182\/blood.V96.5.1703","volume":"96","author":"Warkentin","year":"2000","journal-title":"Blood"},{"key":"10.1160\/TH12-11-0844-2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.95.5.1242"},{"key":"10.1160\/TH12-11-0844-3","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.99.19.2530"},{"key":"10.1160\/TH12-11-0844-4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.11-2303"},{"key":"10.1160\/TH12-11-0844-5","first-page":"659","volume":"40","author":"Carr","year":"1999","journal-title":"J Cardiovasc Surg (Torino)"},{"key":"10.1160\/TH12-11-0844-6","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-06-292938"},{"key":"10.1160\/TH12-11-0844-7","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-7843.2008.00274.x"},{"key":"10.1160\/TH12-11-0844-8","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-198607000-00006"},{"key":"10.1160\/TH12-11-0844-9","doi-asserted-by":"publisher","DOI":"10.1160\/TH09-04-0253"},{"key":"10.1160\/TH12-11-0844-10","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2141.1997.4183225.x"},{"key":"10.1160\/TH12-11-0844-11","unstructured":"Pouplard C, Darnige L, May MA, et al. 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