Dynamics of hemostasis system and c-reactive protein indexes while new oral anticoagulants intake in patients after hip joint endoprosthesis replacement


DOI: https://dx.doi.org/10.18565/therapy.2021.10.55-60

Zamyatina K.N., Saiganov S.A., Mazurov V.I., Gaykovaya L.B., Tkachenko A.N., Urazovskaya I.L., Mansurov D.Sh., Khaidarov V.M., Balgley A.G.

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg
Abstract. Indirect oral anticoagulants use in some cases may be accompanied by an increased risk of bleeding in patients after orthopedic traumatological operations.
The aim of the study was to compare coagulological, biochemical and hematological laboratory parameters while rivaroxaban and apixaban intake in patients after hip arthroplasty (HA) operation.
Material and methods. 38 patients aged 58±15 (33–85) years with hip joint osteoarthritis diagnosis were involved in the study. Laboratory study included the measiring of hemostasis parameters, biochemical parameters and hematological parameters on the analyzer. Rivaroxaban and apixaban concentration was measured in blood plasma using an ACL TOP 500CTS analyzer (Werfen, USA) on the 1st day after surgery and on the 7th day after HA.
Results. In patients receiving rivaroxaban, on the first day after HA, the average Cmax value of rivaroxaban in blood plasma was 122,4 (94–178) ng/ml, at discharge from the hospital – 186,47 (152,8-239) ng/ml, which corresponded to the therapeutic intervals. In patients using apixaban, similar indexes were 60,3 (14–95,2) and 79,85 (14–196,4) ng/ml, which also corresponded to the therapeutic intervals. While taking rivaroxaban, patients showed a statistically significant increase in INR (p <0,05), in contrast to the group of patients receiving apixaban.
Conclusion. Intake of rivaroxaban and apixaban in patients with hip joint osteoarthritis during HA was not accompanied by hemorrhagic complications. Patients in the apixaban group had higher markers of inflammation than in the rivaroxaban group. Taking into account the data obtained during this work when comparing hemostasis and C-reactive protein indexes, it is more preferable to take rivaroxaban in order to reduce the inflammatory response.
Keywords: hip arthroplasty, apixaban, rivaroxaban, hemostasis
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About the Autors

Ksenia N. Zamyatina, postgraduate student at the Department of biological and general chemistry named after V.V. Sokolovsky, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail: ksenija.zamyatina@yandex.ru. ORCID: 0000-0002-6890-6357
Sergey A. Sayganov, MD, professor, rector of I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail: rectorat@szgmu.ru. ORCID: 0000-0001-8325-1937
Vadim I. Mazurov, MD, professor, academician of RAS, Chief scientific consultant, head of the Department of therapy, rheumatology, temporary disability and medical care quality examination named after E.E. Eichwald, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail: rectorat@szgmu.ru. ORCID: 0000-0002-0797-2051
Larisa B. Gaykovaya, MD, associate professor, head of the Department of biological and gleneral chemistry named after V.V. Sokolovsky, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail: Larisa.Gaikovaya@szgmu.ru. ORCID: 0000-0003-1000-1114
Alexander N. Tkachenko, MD, professor, professor of the Department of traumatology, orthopedics and mlilitary field surgery, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. Е-mail: altkachenko@mail.ru. ORCID: 0000-0003-4585-5160
Irina L. Urazovskaya, PhD, assistant of the Department of hospital surgery and cardiologynamed after M.S. Kushakovsky, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail langelova@yandex.ru. ORCID: 0000-0003-4165-4599
Dzhalolidin S. Mansurov, PhD, assistant at the Department of traumatology, orthopedics and military field surgery, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail jalolmedic511@gmail.com. ORCID: 0000-0002-1799-641X
Valery M. Khaidarov, PhD, associate professor of the Department of traumatology, orthopedics and military field surgery, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail: drxaydarov@mail.ru. ORCID: 0000-0002-0754-4348
Alexander G. Balgley, assistant at the Department of traumatology, orthopedics and military field surgery, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 191015, Saint Petersburg, 41 Kirochnaya Str. E-mail: balgley.aleksandr@szgmu.ru. ORCID: 0000-0003-0964-6871


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