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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

Authors :
Monika Štalc
Alenka Mavri
Anja Boc
Tjasa Vizintin-Cuderman
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.

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