title: Assessment of bleeding after concomitant administration of antiplatelet and anticoagulant agents in lower limb arthroplasty.
abstract: In an analysis of the Melagatran Thrombosis Prophylaxis in Orthopedic Surgery (METHRO) III study, we evaluated whether concomitant administration of aspirin (ASA) and non-steroidal anti-inflammatory drugs (NSAIDs) with the direct thrombin inhibitor melagatran/ximelagatran or the low-molecular-weight heparin enoxaparin increased bleeding in patients undergoing major joint surgery. Further objectives were to compare the influence of the timing of initial postoperative administration of melagatran/ximelagatran on bleeding in orthopedic patients receiving ASA/NSAIDs and in comparison with the preoperative administration of enoxaparin. ASA or NSAIDs in conjunction with melagatran/ximelagatran or enoxaparin did not increase bleeding. Bleeding rates were not significantly different, irrespective of the timing of the initial postoperative dose of melagatran/ximelagatran (4-8 vs. 4-12 h) when compared with preoperative (12 h) administration of enoxaparin. Transfusion rates were significantly lower with administration of melagatran/ximelagatran compared with enoxaparin.
authors.affiliation: International Surgical Thrombosis Forum, Thrombosis Research Institute, London, UK. oladahl@start.no
authors.forename: Ola E
authors.initials: OE
authors.lastname: Dahl
authors.forename: Mats
authors.initials: M
authors.lastname: Ogren
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Agnelli
authors.forename: Bengt I
authors.initials: BI
authors.lastname: Eriksson
authors.forename: Alexander T
authors.initials: AT
authors.lastname: Cohen
authors.forename: Patrick
authors.initials: P
authors.lastname: Mouret
authors.forename: Nadia
authors.initials: N
authors.lastname: Rosencher
authors.forename: Anders
authors.initials: A
authors.lastname: Bylock
authors.forename: Seva
authors.initials: S
authors.lastname: Panfilov
authors.forename: Magnus
authors.initials: M
authors.lastname: Andersson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D000925:Anticoagulants / Q000008:administration & dosage*; D001178:Arthroplasty; D001241:Aspirin / Q000008:administration & dosage; D001384:Azetidines / Q000008:administration & dosage*; D001596:Benzylamines / Q000008:administration & dosage*; D001760:Bleeding Time; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D004311:Double-Blind Method; D017984:Enoxaparin / Q000008:administration & dosage; D005060:Europe; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D013019:South Africa; D013927:Thrombosis / Q000517:prevention & control
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D001384:Azetidines; D001596:Benzylamines; D017984:Enoxaparin; D010975:Platelet Aggregation Inhibitors; C109573:melagatran; C426686:ximelagatran; D001241:Aspirin