The relationships among hemostatic markers, the withdrawal of fondaparinux due to a reduction in hemoglobin and deep vein thrombosis in Japanese patients undergoing major orthopedic surgery.

Abstract

BACKGROUND:

The relationships among the hemostatic markers, the development of deep vein thrombosis (DVT) and the withdrawal of fondaparinux due to a reduction in the hemoglobin levels were examined.

METHODS:

Two-hundred twenty-one Japanese patients who underwent major orthopedic surgery and were treated with 1.5mg of fondaparinux instead of 2.5mg of fondaparinux were studied. Forty-seven of 221 patients discontinued fondaparinux treatment (withdrawal group) and 37 patients developed DVT.

RESULTS:

The age, frequency of total knee arthroplasty (TKA), withdrawal of fondaparinux, reduction of hemoglobin and the plasma levels of soluble fibrin (SF), D-dimer and fibrinogen and fibrin degradation product (FDP) on day 1 after the operation were significantly higher in the patients with DVT. Elevated SF, D-dimer or FDP levels were associated with the risk for DVT. The age, frequency of TKA or DVT, anti-Xa activity and the creatinine, FDP and D-dimer levels were significantly higher in the withdrawal group. An anti-Xa level >0.33 mg/l and an elevated D-dimer or FDP level were associated with the risk of withdrawal.

CONCLUSION:

The age and SF levels, TKA and withdrawal of fondaparinux were related to the risk of DVT, and the anti-Xa activity, creatinine level and DVT were related to the risk of withdrawal of fondaparinux due to a reduction in hemoglobin.

• Authors: Masahiro Hasegawa, Hideo Wada, Hiroki Wakabayashi, Kakunoshin Yoshida, Noriki Miyamoto, Kunihiro Asanuma, Takeshi Matsumoto, Kohshi Ohishi, Yuji Shimokariya, Norikazu Yamada, Atsumasa Uchida, Akihiro Sudo
• Journal: Clinica chimica acta; international journal of clinical chemistry (Clin Chim Acta) Vol. 425 Pg. 109-13 (Oct 21 2013) ISSN: 1873-3492 [Electronic] Netherlands
• PMID: 23876378 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2013.

Chemical References

• Anticoagulants
• Biomarkers
• Factor Xa Inhibitors
• Fibrin Fibrinogen Degradation Products
• Hemoglobins
• Polysaccharides
• fibrin fragment D
• thrombus precursor protein, human
• Fibrin
• Fibrinogen
• Factor Xa
• Fondaparinux

Topics

• Age Factors
• Aged
• Aged, 80 and over
• Anemia (blood, chemically induced, pathology)
• Anticoagulants (adverse effects)
• Arthroplasty, Replacement, Knee
• Biomarkers (blood)
• Factor Xa (metabolism)
• Factor Xa Inhibitors
• Female
• Fibrin (metabolism)
• Fibrin Fibrinogen Degradation Products (metabolism)
• Fibrinogen (metabolism)
• Fondaparinux
• Hemoglobins (metabolism)
• Humans
• Male
• Middle Aged
• Polysaccharides (adverse effects)
• Risk Factors
• Venous Thrombosis (blood, drug therapy, pathology)