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Predictive blood coagulation markers for early diagnosis of venous thromboembolism after total knee joint replacement.
MedLine Citation:
PMID:  21839493     Owner:  NLM     Status:  Publisher    
Pulmonary embolism development may be prevented if asymptomatic venous thromboembolism (VTE) can be predicted and treated preoperatively or soon after total knee arthroplasty (TKA). The purpose of this study was to evaluate whether asymptomatic VTE can be predicted by blood coagulation markers preoperatively or early after TKA. This prospective single-centre study enrolled 68 patients (6 men, 62 women; mean age: 71years) who underwent TKA between September 2004 and August 2009. Sixteen-row multidetector computed tomography was performed 4days before and after surgery for diagnosis of asymptomatic VTE. Blood samples were taken to measure the plasma levels of soluble fibrin monomer complex (SFMC), D-dimer and cross-linked fibrin degradation products by leukocyte elastase (e-XDP) at 4days preoperatively, and at 1 hour, 1day and 4days postoperatively. The preoperative SFMC, D-dimer and e-XDP levels did not differ significantly between the thrombus (n=36) and no-thrombus (n=32) groups. D-dimer and e-XDP levels showed the most significant increases at days 4 and 1, respectively, after surgery in the thrombus group. With cut-off points of 7.5μg/ml for D-dimer and 8.2 U/ml for e-XDP, the sensitivities were 75% and 75%, and the specificities were 63% and 59%, respectively. By multiple logistic regression analysis, D-dimer at day 4 and e-XDP at day 1 postoperatively were independent markers for early diagnosis of VTE (odds ratio=1.61 and 1.19, P=0.01 and 0.04, respectively). The postoperative occurrence of new asymptomatic VTE may be predicted by D-dimer at day 4 and e-XDP at day 1 after TKA.
Hideaki Watanabe; Seiji Madoiwa; Hitoshi Sekiya; Yutaka Nagahama; Shirou Matsuura; Yusei Kariya; Tsukasa Ohmori; Jun Mimuro; Yuichi Hoshino; Shinya Hayasaka; Yoichi Sakata
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-8-10
Journal Detail:
Title:  Thrombosis research     Volume:  -     ISSN:  1879-2472     ISO Abbreviation:  -     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-8-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
Department of Orthopaedic Surgery, Jichi Medical University, Tochigi, Japan.
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