Vol. 14 No. 1 (2022): Archives of Public Health
Clinical Science

Presence of anti-TF4/heparin antibodies in patients preoperatively treated with enoxaparine after orthopedic surgery

Natali Jordanovska-Guceva
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius University in Skopje, Faculty of Medicine, Republic of North Macedonia
Andrijan Kartalov
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius in Skopje, Faculty of Medicine, Republic of North Macedonia
Biljana Kuzmanovska
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius in Skopje, Faculty of Medicine, Republic of North Macedonia
Milan Samardziski
University Clinic for Traumatology, Orthopedics, Anesthesiology, Reanimation and Intensive Care; Ss Cyril and Methodius in Skopje, Faculty of Medicine, Republic of North Macedonia
Filip Gucev
University Clinic for reumathology; Ss. Cyril and Methodius University in Skopje, Faculty of Medicine , Republic of North Macedonia

Published 2022-06-23

Keywords

  • heparin-induced thrombocytopenia,
  • anti-PF4/heparin antibodies,
  • total knee or hip arthroplasty,
  • enoxaparine,
  • postoperative risk

How to Cite

1.
Јордановска-Гучева Н, Карталов А, Кузмановска Б, Самарџиски М, Гучев Ф. Presence of anti-TF4/heparin antibodies in patients preoperatively treated with enoxaparine after orthopedic surgery. Arch Pub Health [Internet]. 2022 Jun. 23 [cited 2022 Jul. 7];14(1). Available from: https://www.id-press.eu/aph/article/view/6018

Abstract

Heparin-induced thrombocytopenia (HIT) is a condition caused by antibodies against the platelet factor 4 (PF4)/heparin complex. This significantly increases the risk of bleeding and thrombosis in patients, which is essential in the postoperative period. In this study we examined the rate of seroconversion of anti-PF4/heparin antibodies in patients with rheumatoid arthritis (RA) and osteoarthritis (OA) after total knee or hip arthroplasty. The aims of the study were to assess the risk of HIT by evaluation of induction of anti-PF4/heparin antibodies in patients with RA and OA after total knee or hip arthroplasty, treated prophylactically with enoxaparine. Material and methods: We followed 36 patients aged 18 to 80 years, after total knee or hip arthroplasty, treated prophylactically with enoxaparine. Patients were divided in two groups: patients with RA and patients with OA.  They were examined for occurrence of HIT. Blood was sampled twice, from a peripheral vein, for immunologic tests. The first time it was done before enoxaparine application and the second time postoperatively 10 days after surgery. We noted demographic data, anti-PF4/heparin antibodies, erythrocyte sedimentation rate (ESR), CRP, RF, antiCCP and anti-nuclear antibodies Hep2 (ANA). Results: There was no significant difference in the values of anti-PF4/heparin antibodies in patients with RA and OA preoperatively. The presence of anti-PF4/heparin antibodies was significantly lower in RA patients compared to OA (7.14% versus 27.27%, p=0.034). There was no significant association between levels of anti-PF4/heparin antibodies and ESR, CRP, RF, CCP, ANA. Conclusion: The results obtained showed a lower level of anti-PF4/heparin antibodies in patients with RA than in patients with OA. This shows that there may be a difference in the generation of this antibody in patients with RA compared to patients with OA, prophylactically treated with enoxaparine after total knee or hip arthroplasty.

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