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The Archives of Bone and Joint Surgery، جلد ۱۳، شماره ۵، صفحات ۲۹۱-۲۹۸
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عنوان انگلیسی Anti-PF4/ Heparin Antibodies Early Seroconversion in Hip Fracture Patients Receiving Low Molecular Weight Heparin Prophylaxis: a Pilot Study of 100 Consecutive Patients
چکیده انگلیسی مقاله Objectives: Heparin-induced thrombocytopenia (HIT) represents a serious adverse reaction triggered by antibodies (anti-PF4/H) in heparin regimens. It is not clear if different low-molecular weight heparins (LMWHs) prompt distinct immunogenic responses in anti-PF4/H production and if these antibodies correlate with thrombocytopenia, thrombotic events, and early postoperative mortality. This pilot prospective study investigates the early output of anti-PF4/ H in elderly patients undergoing proximal femoral nailing for an intertrochanteric hip fracture surgery.Methods: A total of 100 consecutive patients (72 females) with surgically treated intertrochanteric hip fractures were prospectively included. Ninety-four patients were available for the final follow-up. Twenty-seven patients received bemiparin, 42 enoxaparin and 25 tinzaparin. The levels of anti-PF4/H using the semi-quantitative latex-enhanced immunoassay; HemosIL® HIT-Ab(PF4-H) and platelets (PLT) levels were measured on the admission day and on day 5 following LMWH administration. Patients were followed up for at least 3 months for major thrombotic events and all-cause mortality.Results: No patient developed clinically evident HIT, while 6 (6.4%) experienced thrombotic complications, and 22 (23.4%) passed away within 3 months after surgery. None of the patients with thrombotic complications tested positive for anti-PF4/H. Upon evaluating patients' seroconversion by day 5, six out of 94 (6.4%) patients tested positive for anti-PF4/H. Among them, three patients received bemiparin, two tinzaparin, and one enoxaparin. No statistically significant variance was observed in anti-PF4/H seroconversion between different types of LMWHs (p-value = 0.545) or in PLT count deviations (p-value = 0.990).Conclusion: This pilot prospective study investigated anti-PF4/H production in older patients with hip fractures receiving different LMWHs. Preliminary results suggest that all tested anticoagulants have similar immunogenicity profiles in terms of PF4/H sensitization. These findings highlight the overall safety of LMWHs in elderly hip fracture patients. Moreover, the presence of anti-PF4/H appears unrelated to PLT fluctuations, subsequent VTE events and early postoperative mortality.        Level of evidence: II
کلیدواژه‌های انگلیسی مقاله anti/ PF4, femoral nail, heparin, Hip fracture, HIT, LMWH
نویسندگان مقاله | Markos Psifis
Department of Orthopaedics and Trauma Surgery, “Venizeleion” General Hospital of Heraklion, Crete, Greece


| Christos Koutserimpas
Department of Anatomy, School of Medicine, Faculty of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece


| Ioannis Stavrakakis
Department of Orthopaedics and Trauma Surgery, “Venizeleion” General Hospital of Heraklion, Crete, Greece


| Chrysostomos Tsatsoulas
Department of Orthopaedics and Trauma Surgery, “Venizeleion” General Hospital of Heraklion, Crete, Greece


| Vasiliki Danilatou
School of Medicine, European University of Cyprus, 2404 Nicosia, Cyprus


| Kalliopi Alpantaki
Department of Orthopaedics and Trauma Surgery, “Venizeleion” General Hospital of Heraklion, Crete, Greece
نشانی اینترنتی https://abjs.mums.ac.ir/article_25617.html
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زبان مقاله منتشر شده en
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نوع مقاله منتشر شده RESEARCH PAPER
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