Artikel
Effect of Rivaroxaban on coagulation parameters in patients undergoing elective orthopaedic surgery
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Autoren
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F. Wenger
- Klinikum der Johann Wolfgang Goethe-Universität Frankfurt, Unfallchirurgie, Frankfurt, Germany
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H. Mani
- Johann Wolfgang Goethe Universität Frankfurt am Main, Gefäßzentrum Frankfurt - Schwerpunkt Angiologie, Frankfurt, Germany
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C. Hesse
- Johann Wolfgang Goethe Universität Frankfurt am Main, Gefäßzentrum Frankfurt - Schwerpunkt Angiologie, Frankfurt, Germany
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E. Lindhoff-Last
- Johann Wolfgang Goethe Universität Frankfurt am Main, Gefäßzentrum Frankfurt - Schwerpunkt Angiologie, Frankfurt, Germany
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A. Meurer
- Johann Wolfgang Goethe-Universität, Orthopädische Uniklinik Friedrichsheim gGmbH, Orthopädie und orthop. Chirurgie, Frankfurt, Germany
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I. Marzi
- Johann Wolfgang Goethe Universität Frankfurt am Main, Klinik für Unfall-, Hand- und Wiederherstellungschirurgie, Frankfurt, Germany
| Veröffentlicht: | 21. Oktober 2010 |
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Gliederung
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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.
