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Prevalence of Heparin Platelet Factor 4 Antibody in Hip Fracture Patients Undergoing Orthopaedic Surgery Treated with Heparin versus Enoxaparin and Their Relevance to Serum Amyloid A
Author(s) -
Griffin Justin,
Litinas Evangelos,
Zhu He,
Hoppensteadt Debra,
Lassen Michael,
Hopkinson William,
Fareed Jawed
Publication year - 2010
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.24.1_supplement.lb432
Subject(s) - medicine , heparin , platelet factor 4 , antibody , thrombosis , low molecular weight heparin , platelet activation , gastroenterology , platelet , surgery , immunology
Orthopaedic surgical interventions often result in the activation of hemostatic and inflammatory processes contributing to the pathophysiology of thrombotic and vascular complications especially in the elderly patient. Anticoagulants represent a standard of care for the management of postoperative thrombosis. Nonfunctional HIT antibodies are also generated in these patients, which may contribute to adverse outcomes. More recently, serum amyloid A (SAA) has also been implicated as an inflammatory mediator after surgical interventions. To investigate the relative prevalence of HIT antibodies and their subtypes, as well as the circulating level of SAA blood samples from elderly patients treated with heparin and enoxaparin (n=50 in each group) were collected at one day prior to and on 1, 3, 5, 7 postoperative days. Circulating levels of HIT antibodies were measured using GTI and Hyphen methods. The subtyping of the antibodies in terms of IgG, A, and M were also studied using the Hyphen kits. The SAA was measured using a commercially available ELISA method (Abazyme, Needham, MA). Patients treated with unfractionated heparin showed a greater prevalence of anti‐heparin platelet factor 4 antibodies as compared to enoxaparin. The heparin group also showed a greater prevealence of the IgG antibodies. Interestingly, SAA levels were increased in both the heparin and enoxaparin treated groups after surgery which persisted in both groups on day 5.