title: Fibrin-related markers for diagnosing acute-, subclinical-, and pre-venous thromboembolism in patients with major orthopedic surgery.
abstract: Venous thromboembolism (VTE) is a common complication in patients who have undergone major orthopedic surgery, but there are few predictors of VTE after major orthopedic surgery treated with an anticoagulant. We measured levels of fibrin-related markers (FRMs), such as D-dimer, soluble fibrin (SF), and fibrinogen and fibrin degradation products (FDPs) in 66 patients with acute-phase VTE, and 367 patients undergoing major orthopedic surgery. Plasma FDP, D-dimer, and SF levels were significantly higher in patients with acute VTE, but only FDP and D-dimer levels were significantly higher in subclinical VTE. Adequate cut-off levels of D-dimer were 2.2 μg/ml for diagnosing acute VTE and 1.5 μg/ml for diagnosing subclinical VTE. D-dimer of less than 1.9 or 0.7 μg/ml ruled out acute VTE or subclinical VTE. D-dimer of more than 1.3 μg/ml preoperatively showed a moderate risk for postoperative VTE. Measurement of FRMs is useful for evaluating the risk of subclinical or postoperative VTE in patients with major orthopedic surgery. In particular, FDP is the most valuable marker for diagnosing acute VTE, whereas D-dimer is the most valuable for diagnosing subclinical VTE or predicting VTE.
authors.affiliation: Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Toshio
authors.initials: T
authors.lastname: Yamaguchi
authors.affiliation: Departments of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City, Mie-ken, 514-8507, Japan. wadahide@clin.medic.mie-u.ac.jp.
authors.forename: Hideo
authors.initials: H
authors.lastname: Wada
authors.affiliation: Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyazaki
authors.affiliation: Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Wakabayashi
authors.affiliation: Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Asanuma
authors.affiliation: Departments of Molecular and Laboratory Medicine, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu-City, Mie-ken, 514-8507, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Fujimoto
authors.affiliation: Blood Transfusion Service, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Matsumoto
authors.affiliation: Blood Transfusion Service, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Kohshi
authors.initials: K
authors.lastname: Ohishi
authors.affiliation: Central Laboratory, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Akane
authors.initials: A
authors.lastname: Sakaguchi
authors.affiliation: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Norikazu
authors.initials: N
authors.lastname: Yamada
authors.affiliation: Department of Cardiology and Nephrology, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ito
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Yamashita
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Katayama
authors.affiliation: Departments of Orthopaedic Surgery, Mie University Graduate School of Medicine, Tsu, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Sudo
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D005337:Fibrin / Q000032:analysis*; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000009:adverse effects; D054556:Venous Thromboembolism / Q000097:blood / Q000175:diagnosis*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005337:Fibrin; D005340:Fibrinogen
keywords: D-dimer; FRMs; Orthopedic surgery; SF; VTE