The Relationship of Platelet Coagulant Activities to Venous Thrombosis following Hip Surgery

Publisher Website
Google Scholar
Abstract
Platelets were recently shown to trigger intrinsic coagulation by 2 alternative pathways, protect active clotting factors from inactivation by plasma inhibitors and catalyze intrinsic coagulation reactions on the platelet surface to form fibrin. To determine whether these platelet coagulant activities (PCA) might have a role in the pathogenesis of DVT [deep vein thrombosis], 29 patients were studied before and after arthroplasty or other surgery for fractured hip or degenerative hip disease. The occurrence of DVT was detected by [125I]fibrinogen uptake in the legs and confirmed by venography. In patients who developed DVT, all PCA increased progressively and significantly on day 1 (mean rise, 146% of baseline), day 3 (228%) and day 5 (298%) after surgery before isotopic evidence of DVT appeared (mean 3.27 days postoperatively). In patients without DVT no changes in PCA were observed. Plasma coagulation factor assays were no different in patients with and without DVT. Platelet counts and total platet antiheparin activity increased during the early postoperative period in DVT patients but not in patients without DVT. Progressive increases in PCA concerned with triggering and catalyzing intrinsic coagulation reactions may play a pathogenetic role in DVT after hip surgery.