title: Thrombin-antithrombin III complexes in the prediction of deep vein thrombosis following total hip replacement.
abstract: In 196 consecutive patients who underwent elective total hip surgery we investigated the diagnostic accuracy of the thrombin-antithrombin III complex immunoassay, as assessed on the first, fourth and tenth postoperative day, for the development of deep vein thrombosis (DVT). Patients received either LMW-heparinoid (n = 97) or placebo (n = 99) and underwent contrast venography on the tenth postoperative day. Thrombin-antithrombin III (T-AT) plasma levels were raised in all patients on the first postoperative day and gradually decreased during the study period. T-AT plasma levels were significantly higher in patients developing DVT when compared to patients without DVT and remained so until day 10. This difference was apparent both in the LMW-heparinoid group as well as in the placebo-treated patients. ROC-curve analysis revealed no satisfactory discriminative power for the diagnosis of developing DVT at any of the studied cut-off values for T-AT. We conclude that the postoperative determination of T-AT complex plasma concentrations in hip surgery patients has no clinical utility in the prediction of postoperative DVT.
authors.affiliation: Centre for Hemostasis, Thrombosis and Atherosclerosis Research, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: J A
authors.initials: JA
authors.lastname: Hoek
authors.forename: M T
authors.initials: MT
authors.lastname: Nurmohamed
authors.forename: J W
authors.initials: JW
authors.lastname: ten Cate
authors.forename: H R
authors.initials: HR
authors.lastname: Büller
authors.forename: H C
authors.initials: HC
authors.lastname: Knipscheer
authors.forename: K J
authors.initials: KJ
authors.lastname: Hamelynck
authors.forename: R K
authors.initials: RK
authors.lastname: Marti
authors.forename: A
authors.initials: A
authors.lastname: Sturk
mesh_terms: D000990:Antithrombin III / Q000032:analysis*; D004796:Clinical Enzyme Tests; D004311:Double-Blind Method; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006622:Hip Prosthesis / Q000009:adverse effects*; D006801:Humans; D007124:Immunoenzyme Techniques; D010447:Peptide Hydrolases / Q000032:analysis*; D010690:Phlebography; D016032:Randomized Controlled Trials as Topic; D013924:Thrombophlebitis / Q000175:diagnosis* / Q000517:prevention & control
chemical_list: D006495:Heparin, Low-Molecular-Weight; C046193:antithrombin III-protease complex; D000990:Antithrombin III; D010447:Peptide Hydrolases