gms | German Medical Science

Deutscher Kongress für Orthopädie und Unfallchirurgie
74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie
96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie
51. Tagung des Berufsverbandes der Fachärzte für Orthopädie und Unfallchirurgie

26. - 29.10.2010, Berlin

Effect of Rivaroxaban on coagulation parameters in patients undergoing elective orthopaedic surgery

Meeting Abstract

  • F. Wenger - Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Unfallchirurgie, Frankfurt, Germany
  • H. Mani - Johann Wolfgang Goethe Universität Frankfurt am Main, Gefäßzentrum Frankfurt - Schwerpunkt Angiologie, Frankfurt, Germany
  • C. Hesse - Johann Wolfgang Goethe Universität Frankfurt am Main, Gefäßzentrum Frankfurt - Schwerpunkt Angiologie, Frankfurt, Germany
  • E. Lindhoff-Last - Johann Wolfgang Goethe Universität Frankfurt am Main, Gefäßzentrum Frankfurt - Schwerpunkt Angiologie, Frankfurt, Germany
  • A. Meurer - Johann Wolfgang Goethe-Universität, Orthopädische Uniklinik Friedrichsheim gGmbH, Orthopädie und orthop. Chirurgie, Frankfurt, Germany
  • I. Marzi - Johann Wolfgang Goethe Universität Frankfurt am Main, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Frankfurt, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie. 74. Jahrestagung der Deutschen Gesellschaft für Unfallchirurgie, 96. Tagung der Deutschen Gesellschaft für Orthopädie und Orthopädische Chirurgie, 51. Tagung des Berufsverbandes der Fachärzte für Orthopädie. Berlin, 26.-29.10.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocIN24-1642

DOI: 10.3205/10dkou151, URN: urn:nbn:de:0183-10dkou1513

Published: October 21, 2010

© 2010 Wenger et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Rivaroxaban (Xarelto®) represents the first oral direct factor Xa inhibitor and is increasingly used for prevention of thrombosis after hip or knee replacement surgery after approval in 2008 in the European Union. Yet iIts influence on laboratory coagulation parameters is unclear and difficulty in post-operative coagulation monitoring is arising. The aim of this study was to investigate the effects of rivaroxaban once-daily (10 mg) on different coagulation parameters in patients undergoing hip and knee replacement surgery.

Methods: Twenty patients (14 female, 6 male) with a mean age of 66 years (range 47–79) after hip (13) or knee (7) replacement surgery treated with rRivaroxaban 10 mg/d were involved in this study., which is approved by the Institutional Review Board of the Frankfurt University Hospital. Plasma samples were obtained before surgery (A) and three times (B-D) on the 3rd till 5th day after surgery:. The three points in time after surgery were before (B), after 2 hours hours (C) and after 12 hours (D) after intake of the daily rRivaroxaban dosing. Global coagulation parameters Prothrombin time (PT) and partial Thromboplastin time (APTT) were measured as well as AT III and Prothrombin time (PT), partial Thromboplastin time (APTT), Ffibrinogen with two methods, and Factor VIII assays done. were performed in the coagulation laboratory of the University Hospital Frankfurt/MainStatistical analysis was performed with SPSS. .

Results and conclusions: In this ongoing study being extended over different coagulation factors, plasma levels of PT and aPTT are altered under intake of rivaroxaban whereas AT III is marginally influenced (Table 1 [Tab. 1]). The plasma level of Fibrinogen is increased after surgery. The changes of PT and aPTT before surgery (A) and in steady-state (B-C) are significant (p<0,01). The prolongation of PT and aPTT reached peak at 2 hours after intake (p<0,001).

Intake of rivaroxaban results in remarkable dynamic changes of PT and aPTT, these effects of rivaroxaban have to be considered in postoperative patient management and coagulation diagnostics.