PMID- 27526543
OWN - NLM
STAT- MEDLINE
DCOM- 20160906
LR  - 20160816
IS  - 0047-1860 (Print)
IS  - 0047-1860 (Linking)
VI  - 62
IP  - 10
DP  - 2014 Oct
TI  - [Monitoring of Anticoagulant Therapy after Orthopedic Surgery].
PG  - 970-5
AB  - Venous thromboembolism (VTE) is a serious, although decreasingly prevalent, 
      complication following major orthopedic surgery, such as total hip replacement 
      and total knee replacement. In Japan, patients undergoing orthopedic surgery are 
      treated with adjusted-dose warfarin, low-dose unfractionated heparin (UFH), 
      fondaparinux, low-molecular-weight heparin (LMWH), and edoxaban postoperatively 
      for VTE prophylaxis. The American College of Chest Physicians guidelines 
      recommend the administration of various anticoagulants, including warfarin, LMWH, 
      UFH, edoxaban, fondaparinux, dabigatran, apixaban, rivaroxaban, and aspirin. 
      Although the prothrombin time (PT) remains constant under monitoring of warfarin 
      therapy, the PT, activated partial thromboplastin time (APTT), and anti-Xa 
      activity may vary under monitoring of treatment with UFH, LMWH, fondaparinux, 
      and/or novel oral anticoagulants (NOACs). Therefore, the monitoring of selective 
      anti-Xa drugs has not yet been established. A marked prolongation of the APTT and 
      PT values in patients treated with NOACs indicates a risk of bleeding, whereas 
      low levels of D-dimer and soluble fibrin suggest the usefulness of anticoagulants 
      for VTE prophylaxis. An elevation of the anti-Xa activity on day 1 in addition to 
      a marked elevation of the D-dimer level reflect the risk of major bleeding in 
      patients undergoing orthopedic surgery treated with fondaparinux postoperatively. 
      However, there are currently no biomarkers for the efficacy of selective Xa or 
      thrombin inhibitors. Therefore, it is necessary to establish further evidence for 
      monitoring the effects of NOACs.
FAU - Wada, Hideo
AU  - Wada H
FAU - Matsumoto, Takeshi
AU  - Matsumoto T
FAU - Aota, Takumi
AU  - Aota T
LA  - jpn
PT  - English Abstract
PT  - Journal Article
PT  - Review
PL  - Japan
TA  - Rinsho Byori
JT  - Rinsho byori. The Japanese journal of clinical pathology
JID - 2984781R
RN  - 0 (Anticoagulants)
RN  - 9005-49-6 (Heparin)
SB  - IM
MH  - Anticoagulants/*therapeutic use
MH  - Hemorrhage/prevention & control
MH  - Heparin/*therapeutic use
MH  - Humans
MH  - *Orthopedics
MH  - *Partial Thromboplastin Time
MH  - Venous Thromboembolism/*drug therapy
EDAT- 2014/10/01 00:00
MHDA- 2016/09/07 06:00
CRDT- 2016/08/17 06:00
PHST- 2016/08/17 06:00 [entrez]
PHST- 2014/10/01 00:00 [pubmed]
PHST- 2016/09/07 06:00 [medline]
PST - ppublish
SO  - Rinsho Byori. 2014 Oct;62(10):970-5.