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C0091 High levels of D-dimer and previous provoked venous thromboembolism are risk factors for recurrent idiopathic venous thrombosis
C0091 High levels of D-dimer and previous provoked venous thromboembolism are risk factors for recurrent idiopathic venous thrombosis
- Source :
- Thrombosis Research. 130:S132
- Publication Year :
- 2012
- Publisher :
- Elsevier BV, 2012.
-
Abstract
- postoperative VTE; 2) determination of adequate, economicallyreasonable, comprehensive prophylaxis of VTE; 3) monitoring of effectiveness of treatment; 4) Early diagnosis and treatment of DVT and averting of complications. The aim of our study is to analyze the results of postoperative VTE prophylaxis and the possibilities for monitoring efficacy and safety. Methods: Results of VTE prophylaxis in 330 patients who had undergone various surgical procedures from 2005 to April 2012 at Botkin Hospital were analyzed. Age ranged from 25 to 84 years. Male patients numbered 75 (22.7%), female 255 (77.3%). General surgery patients numbered 178 (53.9%), gynecologic 108 (32.7%), urologic 44 (13.3%). Low molecular weight heparin (LMWH) was used for VTE prophylaxis (Enoxaparin Sodium Italfarmaco S.p.A. and Sanofi, Nadroparin Calcium – GlaxoSmithKline plc, Dalteparin Sodium – Pfizer, Inc.). In 124 patients (group A), LMWH was given 12 hrs prior to surgery until recovery of full activity (7–10 days), 90 (group B) received LMWH starting 6–12 hrs after surgery until full recovery, and 116 (controls) did not receive LMWH prophylaxis. For early detection of DVT, analysis of thrombus structure, 6determination of proximal thrombus edge, and monitoring of treatment efficacy, ultrasound scanning was performed before surgery and on the 7-8th day after surgery. Ventilation-perfusion (V/Q) lung scanning was performed in 15 patients. All 330 patients received some form of lower extremity compression to increase venous blood flow: VENOTEKS® THERAPY anti-embolism compression stockings in 280 (84.8%) patients and generic elastic bandages in 50 (15.2%) patients. Coagulation tests were performed in all patients. Results: In groupA, noDVTs or PEswere detected. In group B, DVTwas detected in 6 (6.7%)* and PE in 1 (1.1%)* patient. In the controls, DVT was detected in 32 (27.6%)* and PE in 4 (3.4%)* patients. *pb0.05 for DVT and PE rates between these groups. In 30 (79%) of the patientswith DVT, a decreasing trend in platelet count was observed following DVT diagnosis, indicating a continuing consumption of platelets. In groups A & B, a small increase in Soluble Fibrin Monomer Complex (SFMC) was observed, along with a decrease and subsequent increase in activity of Antithrombin III (AT III) and Protein C (PC). In patients with DVT, a decrease in SFMC was practically not seen; rather, discordance of AT III and PC was observed. Comment: In our experience, the optimal regime for combination VTE prophylaxis (LMWH in combinationwith lower extremity compression stockings/bandaging), with no increase in adverse events, is the regime in which LMWH prophylaxis is started prior to surgery.
- Subjects :
- Dalteparin sodium
medicine.drug_class
business.industry
medicine.medical_treatment
Low molecular weight heparin
Compression stockings
Hematology
medicine.disease
Nadroparin calcium
Venous thrombosis
Anesthesia
D-dimer
medicine
cardiovascular diseases
Thrombus
business
Enoxaparin sodium
medicine.drug
Subjects
Details
- ISSN :
- 00493848
- Volume :
- 130
- Database :
- OpenAIRE
- Journal :
- Thrombosis Research
- Accession number :
- edsair.doi...........ee7a9a45038493b43e5f1cf8f4db2d4e
- Full Text :
- https://doi.org/10.1016/j.thromres.2012.08.082