IgG-class anti-PF4/heparin antibodies and symptomatic DVT in orthopedic surgery patients receiving different anti-thromboembolic prophylaxis therapeutics

BMC Musculoskeletal Disorders

Research Article

Yuka Jiuchi¹  Kiyoshi Migita¹  Yumi Maeda¹  Takafumi Torigoshi²  Kazushige Maeda²  Shinsuke Someya²  Takayuki Yamaguchi²  Satoru Motokawa²  Hiroyuki Shindo³ 

[1] Clinical Research Center, NHO Nagasaki Medical Center, Kubara 2-1001-1, 856-8652, Omura, Japan;Department of Orthopedics Surgery and Department of Rheumatology, NHO Nagasaki Medical Center, Japan;Department of Orthopedics Surgery, Nagasaki University School of Medicine, Sakamoto 1-7-1, 852-8501, Nagasaki, Japan;

关键词: Total Knee Arthroplasty;    Deep Vein Thrombosis;    Enoxaparin;    Unfractionated Heparin;    Fondaparinux;   

DOI  :  10.1186/1471-2474-12-22

 received in 2010-07-14, accepted in 2011-01-24,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundHeparin-induced thrombocytopenia (HIT) is a thromboembolic complication that can occur with unfractionated heparin (UFH) or low molecular weight heparin (LMWH). Our objective was to determine and compare the incidence of IgG-class HIT antibodies in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) with different antithrombotic prophylaxis therapies and their contributions to the occurrence of venous thromboembolism (VTE).MethodsA prospective observational study was performed for 374 Japanese patients undergoing THA or TKA to determine the incidence of VTE. IgG-class anti-PF4/heparin antibodies were measured using IgG-specific EIA before and after the operation.ResultsIn the clinical outcome, the incidence of symptomatic deep vein thrombosis (DVT) was 15.0% (56/374, TKA; 35, THA; 21) and pulmonary emboli (PE) were not observed. The total seroconversion incidence of IgG-class PF4/heparin antibodies was 19.8% (74/374). The seroconversion incidence of IgG-class PF4/heparin antibodies was higher in patients receiving UFH (32.7%) compared to those receiving LMWH (9.5%) or fondaparinux (14.8%). Furthermore, the seroconversion incidence was significantly higher in patients undergoing TKA compared to those undergoing THA. Based on multivariate analysis, seroconversion of the IgG-class PF4/heparin antibodies was independent a risk factor for symptomatic DVT.ConclusionOur findings show that the seroconversion of IgG-class anti-PF4/heparin antibodies differed with various anti-thrombotic prophylaxis therapeutics and was associated with the risk of DVT in a subset of patients undergoing total joint arthroplasty (TKA and THA).

【 授权许可】

Unknown   
© Motokawa et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.