[New oral anticoagulants for thromboprophylaxis under routine use of tranexamic acid after hip joint arthroplasty]. 2014

T A Zhirova, and M S Lykov, and M N Zyrianov, and V N Babushkin

OBJECTIVE To evaluate the efficacy and safety of the novel oral anticoagulants under conservative hemostasis with tranexamic acid in hip arthroplasty. METHODS All patients received 40 mg of enoxaparin 12 hours prior to surgery and on the operating day, and then they received either 10 mg of rivaroxaban (40 patients), 220 mg of dabigatran (42 patients) or 40 mng of enoxaparin (39 patients). Tranexamic acid with doses of 10 - 20 mg/kg was administered to all patients: within 30 minutes prior to surgery and 6 hours after the first infision. The hemorrhagic and thrombotic complications in a hospital outpatient therapy and outcomes in 35 days after surgery were evaluated. RESULTS Minor bleeding was observed only in the rivaroxaban group, the complications rate in hospital was 2.5%, among outpatients 3.1%. At hospital discharge the DVT was 12.5% in rivaroxaban group, 7% in dabigatran and 8% in enoxaparin group (p>0.05). Asymptomatic distal DVT was found in 82% of patients by ultrasound screening. CONCLUSIONS The new oral anticoagulants are effective and safe for venous thromboembolism preventing after hip re placement. Routine use of tranexamic acid was not accompanied by increased risk of DVT

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D005260 Female Females
D006488 Hemostasis, Surgical Control of bleeding during or after surgery. Surgical Hemostasis,Hemostases, Surgical,Surgical Hemostases
D006621 Hip Joint The joint that is formed by the articulation of the head of FEMUR and the ACETABULUM of the PELVIS. Acetabulofemoral Joint,Acetabulofemoral Joints,Hip Joints,Joint, Acetabulofemoral,Joint, Hip,Joints, Acetabulofemoral,Joints, Hip
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000284 Administration, Oral The giving of drugs, chemicals, or other substances by mouth. Drug Administration, Oral,Administration, Oral Drug,Oral Administration,Oral Drug Administration,Administrations, Oral,Administrations, Oral Drug,Drug Administrations, Oral,Oral Administrations,Oral Drug Administrations
D000925 Anticoagulants Agents that prevent BLOOD CLOTTING. Anticoagulant Agent,Anticoagulant Drug,Anticoagulant,Anticoagulant Agents,Anticoagulant Drugs,Anticoagulation Agents,Indirect Thrombin Inhibitors,Agent, Anticoagulant,Agents, Anticoagulant,Agents, Anticoagulation,Drug, Anticoagulant,Drugs, Anticoagulant,Inhibitors, Indirect Thrombin,Thrombin Inhibitors, Indirect
D000933 Antifibrinolytic Agents Agents that prevent fibrinolysis or lysis of a blood clot or thrombus. Several endogenous antiplasmins are known. The drugs are used to control massive hemorrhage and in other coagulation disorders. Antifibrinolysin,Antifibrinolysins,Antifibrinolytic,Antifibrinolytic Agent,Antiplasmin,Antiplasmins,Antifibrinolytics,Plasmin Inhibitor,Plasmin Inhibitors,Agent, Antifibrinolytic,Agents, Antifibrinolytic,Inhibitor, Plasmin,Inhibitors, Plasmin

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