Association between plasma levels of tissue plasminogen activator and postoperative deep vein thrombosis-influence of prophylaxis with a low molecular weight heparin

Sørensen, Jesper Roed; Borris, Lars C.; Lassen, Michael R.; Christiansen, Hanne M.; Schøtt, P; Olsen, Anders; Neerstrand, H.

doi:10.1016/0049-3848(90)90278-k

Cited by 18 publications

(5 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Plasma PAP reflects clot formation and fibrin degradation and is regarded as an index of recent fibrinolytic activity [29]. Results from previous investigations with other biomarkers indicated that decreased fibrinolytic activity was associated with thromboembolism after surgery [20, 21]. The data from these studies are consistent with the PAP pattern in our study.…”

Section: Discussionsupporting

confidence: 90%

“…Furthermore, they have been proposed as surrogate endpoints of bleeding and venous thromboembolism (VTE) and to be of prognostic value to assess clinical outcome [20, 21]. F1+2 fragment is produced when prothrombin is converted to thrombin which acts on fibrin to form blood clots [22], while plasmin/ α 2-antiplasmin complex (PAP) and D-dimer have been found to be valuable markers of fibrinolytic activity during THA [23].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Biomarkers of Coagulation and Fibrinolysis during Cemented Total Hip Arthroplasty with Pre- versus Postoperative Start of Thromboprophylaxis

2013

View full text Add to dashboard Cite

Venous thrombosis is common in elective hip surgery, and prophylaxis is recommended. Clinical trials suggest that the drug dose and timing of initiating prophylaxis significantly influence antithrombotic effectiveness and safety. We studied the time course and gradient of plasma coagulation and fibrinolysis during total hip arthroplasty (THA) in twenty patients that were randomly assigned to have the first dose of 5000 IU dalteparin subcutaneously (sc) injected 12 hours before or 6 hours after surgery. Baseline characteristics were similar in both groups. Specific biomarkers on coagulation (prothrombin fragment 1+2 (F1+2)) and fibrinolytic activity (plasmin/α2-antiplasmin complex (PAP) and D-dimer) were collected at six events during hospitalization and analysed. There were no significant group differences in the biomarkers at any time point. The highest concentrations were measured 6 hours after surgery and before the first postoperative injection. A marked decrease followed at the first postoperative day, and then a second increase in plasma concentrations was observed 6 days after surgery. This study showed that activation of coagulation and fibrinolysis by the operative trauma was the same when the first dose of dalteparin was injected 12 hours before or 6 hours after surgery.

show abstract

Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Biomarkers of Coagulation and Fibrinolysis during Cemented Total Hip Arthroplasty with Pre- versus Postoperative Start of Thromboprophylaxis

2013

View full text Add to dashboard Cite

show abstract

“…Plasma PAP reflects clot formation and fibrin degradation and is regarded as an index of recent fibrinolytic activity [29]. Results from previous investigations with other Thrombosis 5 biomarkers indicated that decreased fibrinolytic activity was associated with thromboembolism after surgery [20,21]. The data from these studies are consistent with the PAP pattern in our study.…”

Section: Discussionsupporting

confidence: 90%

“…Several biomarkers have been used to study haemostatic response to surgery [18,19]. Furthermore, they have been proposed as surrogate endpoints of bleeding and venous thromboembolism (VTE) and to be of prognostic value to assess clinical outcome [20,21]. F1+2 fragment is produced when prothrombin is converted to thrombin which acts on fibrin to form blood clots [22], while plasmin/𝛼2-antiplasmin complex (PAP) and D-dimer have been found to be valuable markers of fibrinolytic activity during THA [23].…”

Section: Introductionmentioning

confidence: 99%

Preoperative versus Postoperative Initiation of Dalteparin Thromboprophylaxis in THA

2010

View full text Add to dashboard Cite

Chemical thromboprophylaxis in total hip arthroplasty (THA) may increase surgical site bleeding. The drug dose and timing of such therapy is therefore important. We studied two cohorts of 298 and 301 patients undergoing THA. The first group received their first dose of dalteparin sodium 5000 IU subcutaneously the evening before surgery and the second group a half dose six hours postoperatively, followed by 5000 units daily in both groups. Blood loss was reduced by 146 ml from 1230 ml to 1084 ml (p<0.001) with postoperative prophylaxis alone. The number of patients receiving blood transfusion decreased from 53% to 35% (p=0.001), and the use of transfused packed red blood cells was reduced from 1.25 to 0.83 units per patient (p=0.001). The overall rates of non-vascular complications 6 months after surgery were 12% and 11%, bleeding related events 6.0% and 4.0%, and thromboembolic related events were 2.0% and 2.3% in the preoperative and the postoperative cohorts. Two patients died in the preoperative group and one in the postoperative group due to venous and arterial thromboembolism. This study show that 2500 IU dose of dalteparin started 6 hours after surgery significantly reduced blood loss and transfusions compared to 5000 IU dalteparin injected 12 hours before surgery. Few thromboembolic events occurred, and these were equally distributed.

show abstract

“…Several studies have measured biological markers of fibrinolysis (such as D-Dimers, plasmin, antiplasmin, and t-PA) and coagulation (e.g., prothrombin fragment 1.2, PAI-1) perioperatively in major orthopedic surgery. A reduced fibrinolytic activity may be associated with increased thrombotic risk [ 22 , 23 ]. In this study, we used coagulation and fibrinolytic markers (as D-dimer, fibrinogen, plasmin inhibitor (PI), plasminogen (PLG), plasminogen activator inhibitor type 1 (PAI-1), and tissue plasminogen activator (t-PA)) to evaluate the systemic event after application of IA-TXA.…”

Section: Discussionmentioning

confidence: 99%

An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety

Sa-ngasoongsong

Chanplakorn

Wongsak

et al. 2015

BioMed Research International

View full text Add to dashboard Cite

Background. Recently, combined intra-articular tranexamic acid (IA-TXA) injection with clamping drain method showed efficacy for blood loss and transfusion reduction in total knee replacement (TKR). However, until now, none of previous studies revealed the effect of this technique on pharmacokinetics, coagulation, and fibrinolysis. Materials and Methods. An experimental study was conducted, during 2011-2012, in 30 patients undergoing unilateral TKR. Patients received IA-TXA application and then were allocated into six groups regarding clamping drain duration (2-, 4-, 6-, 8-, 10-, and 12-hours). Blood and drainage fluid were collected to measure tranexamic acid (TXA) level and related coagulation and fibrinolytic markers. Postoperative complication was followed for one year. Results. There was no significant difference of serum TXA level at 2 hour and 24 hour among groups (p < 0.05). Serum TXA level at time of clamp release was significantly different among groups with the highest level at 2 hour (p < 0.0001). There was no significant difference of TXA level in drainage fluid, postoperative blood loss, blood transfusion, and postoperative complications (p < 0.05). Conclusions. Low-dose IA-TXA application in TKR with prolonged clamping drain method is a safe and effective blood conservative technique with only minimal systemic absorption and without significant increase in systemic absorption over time.

show abstract

Association between plasma levels of tissue plasminogen activator and postoperative deep vein thrombosis-influence of prophylaxis with a low molecular weight heparin

Cited by 18 publications

References 19 publications

Biomarkers of Coagulation and Fibrinolysis during Cemented Total Hip Arthroplasty with Pre- versus Postoperative Start of Thromboprophylaxis

Biomarkers of Coagulation and Fibrinolysis during Cemented Total Hip Arthroplasty with Pre- versus Postoperative Start of Thromboprophylaxis

Preoperative versus Postoperative Initiation of Dalteparin Thromboprophylaxis in THA

An In Vivo Study of Low-Dose Intra-Articular Tranexamic Acid Application with Prolonged Clamping Drain Method in Total Knee Replacement: Clinical Efficacy and Safety

Contact Info

Product

Resources

About