PMID- 21261941
OWN - NLM
STAT- MEDLINE
DCOM- 20111205
LR  - 20211020
IS  - 1471-2474 (Electronic)
IS  - 1471-2474 (Linking)
VI  - 12
DP  - 2011 Jan 24
TI  - IgG-class anti-PF4/heparin antibodies and symptomatic DVT in orthopedic surgery 
      patients receiving different anti-thromboembolic prophylaxis therapeutics.
PG  - 22
LID - 10.1186/1471-2474-12-22 [doi]
AB  - BACKGROUND: Heparin-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). METHODS: A 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. RESULTS: In 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. CONCLUSION: Our 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).
FAU - Motokawa, Satoru
AU  - Motokawa S
AD  - Department of Orthopedics Surgery and Department of Rheumatology, NHO Nagasaki 
      Medical Center, Japan.
FAU - Torigoshi, Takafumi
AU  - Torigoshi T
FAU - Maeda, Yumi
AU  - Maeda Y
FAU - Maeda, Kazushige
AU  - Maeda K
FAU - Jiuchi, Yuka
AU  - Jiuchi Y
FAU - Yamaguchi, Takayuki
AU  - Yamaguchi T
FAU - Someya, Shinsuke
AU  - Someya S
FAU - Shindo, Hiroyuki
AU  - Shindo H
FAU - Migita, Kiyoshi
AU  - Migita K
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20110124
PL  - England
TA  - BMC Musculoskelet Disord
JT  - BMC musculoskeletal disorders
JID - 100968565
RN  - 0 (Autoantibodies)
RN  - 0 (Immunoglobulin G)
RN  - 37270-94-3 (Platelet Factor 4)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Autoantibodies/*biosynthesis/blood/classification
MH  - Female
MH  - Heparin/*adverse effects/*immunology
MH  - Humans
MH  - Immunoglobulin G/biosynthesis/blood/*classification
MH  - Male
MH  - Middle Aged
MH  - Platelet Factor 4/adverse effects/*immunology
MH  - Prospective Studies
MH  - Venous Thrombosis/*diagnosis/drug therapy/*etiology
PMC - PMC3224260
EDAT- 2011/01/26 06:00
MHDA- 2011/12/13 00:00
PMCR- 2011/01/24
CRDT- 2011/01/26 06:00
PHST- 2010/07/14 00:00 [received]
PHST- 2011/01/24 00:00 [accepted]
PHST- 2011/01/26 06:00 [entrez]
PHST- 2011/01/26 06:00 [pubmed]
PHST- 2011/12/13 00:00 [medline]
PHST- 2011/01/24 00:00 [pmc-release]
AID - 1471-2474-12-22 [pii]
AID - 10.1186/1471-2474-12-22 [doi]
PST - epublish
SO  - BMC Musculoskelet Disord. 2011 Jan 24;12:22. doi: 10.1186/1471-2474-12-22.