Assessment of bleeding after concomitant administration of antiplatelet and anticoagulant agents in lower limb arthroplasty.
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.
Dahl
Ola E
OE
International Surgical Thrombosis Forum, Thrombosis Research Institute, London, UK. oladahl@start.no
Ogren
Mats
M
Agnelli
Giancarlo
G
Eriksson
Bengt I
BI
Cohen
Alexander T
AT
Mouret
Patrick
P
Rosencher
Nadia
N
Bylock
Anders
A
Panfilov
Seva
S
Andersson
Magnus
M
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
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D001384:Azetidines; D001596:Benzylamines; D017984:Enoxaparin; D010975:Platelet Aggregation Inhibitors; C109573:melagatran; C426686:ximelagatran; D001241:Aspirin