Dynamic changes of coagulation and fibrinolytic biomarkers in perioperaive arthroplasty patients

Authors

  • Cong Wang Department of Emergency, Beijing Jishuitan Hospital, Peking, China
  • Songjie Ji Department of Orthopaedic, Beijing Jishuitan Hospital, Peking, China
  • Zhifang Chen Department of Emergency, Beijing Jishuitan Hospital, Peking, China
  • Zhiwei Liu Department of Emergency, Beijing Jishuitan Hospital, Peking, China
  • Heng Zhou Department of Emergency, Beijing Jishuitan Hospital, Peking, China
  • Chunmin Li Department of Orthopaedic, Beijing Jishuitan Hospital, Peking, China
  • Bin Zhao Department of Emergency, Beijing Jishuitan Hospital, Peking, China
  • Chunsheng Li Department of Emergency, Beijing Chao-Yang Hospital, Capital Medical University, Peking, China

DOI:

https://doi.org/10.47391/JPMA.748

Abstract

Abstract

Objective: To evaluate Coagulation and fibrinolytic parameters after total joint arthroplasty (TJA) and provide evidence for optimization of timing of perioperative anticoagulation medicine.

Methods: The prospective study was conducted at the Jishuitan Hospital of Peking University from January to April in 2016, and comprised patients who were scheduled consecutively to undergo primary total knee arthroplasty (TKA) or total hip arthroplasty (THA). Blood samples were obtained at day 1 preoperatively and day1, day 3 postoperatively. Antigenic levels of protein C (PC), endothelial protein C receptor (EPCR), tissue factor pathway inhibitor (TFPI), antithrombin III (AT-III), plasminogen activator inhibitor 1 (PAI-1) and tissue plasminogen activator (tPA) were measured with commercially available enzyme-linked immunosorbent assay kits.

Results: Postoperative levels of coagulation parameters TFPI and AT-III were increased compared to preoperative values (118.7±34.6 vs 70.0±20.5 ?g/ml for AT-III, and 26.37±7.91vs 16.68±8.92 ?g/l for TFPI), while postoperative levels of coagulation parameters PC and EPCR were decreased (0.88±0.30 vs 2.03±0.66 ?g/ml for PC, and 100.8±31.0 vs 199.4±57.4 ?g/ml for EPCR). Postoperative levels of fibrinolytic parameter tPA was increased compared to preoperative values (2.87±0.83 vs 2.03±1.03 ?g/l), while its specific inhibitor PAI-1 was decreased (0.88±0.30 vs 2.03±0.66 ?g/l).

Conclusion: These results demonstrated the perturbation of the coagulation and fibrinolytic system of patients undergoing TJA. Hypercoagulation and hyperfibrinolysis were observed in postoperative patients, which suggested anticoagulant therapy is effective and necessary.

Keywords?Total joint arthroplasty, anticoagulation, fibrinolysis

Published

2020-09-30

How to Cite

Cong Wang, Songjie Ji, Zhifang Chen, Zhiwei Liu, Heng Zhou, Chunmin Li, Bin Zhao, & Chunsheng Li. (2020). Dynamic changes of coagulation and fibrinolytic biomarkers in perioperaive arthroplasty patients. Journal of the Pakistan Medical Association. https://doi.org/10.47391/JPMA.748

Issue

Section

Original Article