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Edoxaban Enhances Thromboprophylaxis by Physiotherapy After Total Knee Arthroplasty　― The Randomized Controlled ESCORT-TKA Trial

Sueta, Daisuke ; Kaikita, Koichi ; Okamoto, Nobukazu ; Yamabe, Soichiro ; Ishii, Masanobu ; Arima, Yuichiro ; Ito, Miwa ; Oimatsu, Yu ; Mitsuse, Tatsuro ; Iwashita, Satomi ; Nakamura, Eiichi ; Hokimoto, Seiji ; Mizuta, Hiroshi ; Ogawa, Hisao ; Tsujita, Kenichi ; for the ESCORT-TKA Study Investigators

Circulation Journal, 2018/01/25, Vol.82(2), pp.524-531 [Periódico revisado por pares]

Japan: The Japanese Circulation Society

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Título:
Edoxaban Enhances Thromboprophylaxis by Physiotherapy After Total Knee Arthroplasty　― The Randomized Controlled ESCORT-TKA Trial
Autor: Sueta, Daisuke ; Kaikita, Koichi ; Okamoto, Nobukazu ; Yamabe, Soichiro ; Ishii, Masanobu ; Arima, Yuichiro ; Ito, Miwa ; Oimatsu, Yu ; Mitsuse, Tatsuro ; Iwashita, Satomi ; Nakamura, Eiichi ; Hokimoto, Seiji ; Mizuta, Hiroshi ; Ogawa, Hisao ; Tsujita, Kenichi ; for the ESCORT-TKA Study Investigators
Assuntos: Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Knee - adverse effects ; Combined Modality Therapy - methods ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Physical Therapy Modalities ; Postoperative Complications - prevention & control ; Pyridines - pharmacology ; Pyridines - therapeutic use ; Randomized controlled trial ; Thiazoles - pharmacology ; Thiazoles - therapeutic use ; Thrombosis - diagnosis ; Thrombosis - prevention & control ; Thrombosis - therapy ; Total knee arthroplasty ; Total Thrombus-formation Analysis System (T-TAS) ; Venous thromboembolism ; Venous Thromboembolism - prevention & control ; Venous Thromboembolism - therapy
É parte de: Circulation Journal, 2018/01/25, Vol.82(2), pp.524-531
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-News-1
ObjectType-Feature-3
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Descrição: Background:The pharmacological advantage of combining physiotherapy with anticoagulants for the prevention of venous thromboembolism (VTE) after total knee arthroplasty (TKA) is not fully known. Herein we investigated the potential benefit of this combination therapy in patients undergoing TKA.Methods and Results:The 38 patients were randomly assigned to a physiotherapy group (n=19) or a physiotherapy plus 30 mg/day edoxaban group (n=19). The occurrence of VTE was evaluated, as were serial changes in parameters measured by the Total Thrombus-formation Analysis System, a novel system for quantitatively analyzing thrombus formation using microchips with thrombogenic surfaces (collagen plus tissue factor, atheroma [AR]-chip). Combination therapy significantly reduced the incidence of VTE after TKA compared with monotherapy (P=0.038). The area under the curve (AUC) of thrombus formation for the AR-chip (AR10-AUC30) was significantly lower in the combination group (P=0.001) on Day 7 after TKA than before TKA, but no significant change was observed with monotherapy (P=0.809). In 13 VTE-positive patients, AR10-AUC30was significantly lower in the combination group (n=3) than in the monotherapy group (n=10) on Day 7 (P=0.045).Conclusions:The combination of physiotherapy and edoxaban significantly reduced the incidence of VTE after TKA compared with physiotherapy alone. However, it is possible that VTE occurrence after TKA is not only associated with thrombogenicity, but also rheological factors.
Editor: Japan: The Japanese Circulation Society
Idioma: Inglês

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Edoxaban Enhances Thromboprophylaxis by Physiotherapy After Total Knee Arthroplasty ― The Randomized Controlled ESCORT-TKA Trial

Japan: The Japanese Circulation Society

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Edoxaban Enhances Thromboprophylaxis by Physiotherapy After Total Knee Arthroplasty　― The Randomized Controlled ESCORT-TKA Trial