Sustained prothrombotic profile after hip replacement surgery: the influence of prolonged prophylaxis with dalteparin (original) (raw)

In a randomized trial on the effect of dalteparin for 5 weeks after HRS we evaluated hemostatic variables in plasma sampled before and 1, 6 and 35 days postoperatively. In 218 patients we found that prothrombin fragment 1 2 (F1 2), thrombin±antithrombin complexes (TAT), D-dimer and ®brinogen were signi®cantly higher on day 35 as compared with baseline values in the placebo group (P < 0.001 for all). The same pattern was found in the dalteparin group, but with signi®cantly lower values for F1 2, TAT and D-dimer. In patients in the placebo group with venographically proven deep vein thrombosis (DVT) on day 35 (33%), signi®cantly higher values were found for F1 2, TAT and D-dimer than in patients without DVT. Patients in the highest quartile of D-dimer (>2850 ng mL À1 ) had an odds ratio for the presence of DVT of 24.0 when compared with patients in the lowest quartile (<1625 ng mL À1 ). It is concluded that a substantial hypercoagulability is sustained until day 35 after HRS, signi®cantly reduced with prolonged administration of dalteparin.