Comparison of Apixaban and Low Molecular Weight Heparin in Preventing Deep Venous Thrombosis after Total Knee Arthroplasty in Older Adults
10.3349/ymj.2019.60.7.626
- Author:
Hui JIANG
1
;
Jia MENG
;
Ting GUO
;
Jian ning ZHAO
;
Yi cun WANG
;
Jun WANG
;
Yang QIU
;
Hao DING
Author Information
1. Department of Orthopedics, Jinling Hospital, Nanjing Clinical School of the Second Military Medical University, Nanjing, Jiangsu, China. guoting439h@163.com, zhaojianning578h@163.com
- Publication Type:Original Article
- Keywords:
Apixaban;
low molecular weight heparin;
total knee arthroplasty;
deep venous thrombosis
- MeSH:
Adult;
Arthroplasty, Replacement, Knee;
Blood Platelets;
Capillaries;
Erythrocyte Aggregation;
Fibrinogen;
Heparin, Low-Molecular-Weight;
Humans;
Incidence;
Plasma;
Prothrombin Time;
Research Subjects;
Thromboplastin;
Venous Thrombosis;
Viscosity
- From:Yonsei Medical Journal
2019;60(7):626-632
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To compare the effect of apixaban and low molecular weight heparin (LMWH) in the prevention and treatment of deep venous thrombosis (DVT) after total knee arthroplasty in older adult patients. MATERIALS AND METHODS: A total of 220 patients (average age of 67.8±6.4 years) undergoing total knee arthroplasty were randomly selected as research subjects and were divided into apixaban and LMWH groups (110 in each group). RESULTS: The incidence of DVT was lower in the apixaban group than in the LMWH group (5.5% vs. 20.0%, p=0.001). Activated partial thromboplastin times (35.2±3.6 sec vs. 33.7±2.2 sec, p=0.010; 37.8±4.6 sec vs. 34.1±3.2 sec, p<0.001; 39.6±5.1 sec vs. 35.7±3.0 sec, p=0.032) and prothrombin times (14.0±1.0 sec vs. 12.8±0.9 sec, p<0.001; 14.5±1.2 sec vs. 13.0±1.1 sec, p<0.001; 15.3±1.4 sec vs. 13.2±1.3 sec, p=0.009) in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were higher than those in the LMWH group. Platelet and fibrinogen levels in the apixaban group were lower than those of the LMWH group. Also, capillary plasma viscosity and erythrocyte aggregation in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were lower than those in the LMWH group. CONCLUSION: Apixaban, which elicits fewer adverse reactions and is safer than LMWH, exhibited better effects in the prevention and treatment of DVT after total knee arthroplasty in older adults.
