Utility of Noninvasive Endothelial Function Test for Prediction of Deep Vein Thrombosis After Total Hip or Knee Arthroplasty
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- Suzuki Hiroyuki
- Division of Cardiology, Yokohama City University Medical Center
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- Matsuzawa Yasushi
- Division of Cardiology, Yokohama City University Medical Center
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- Konishi Masaaki
- Division of Cardiology, Yokohama City University Medical Center
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- Akiyama Eiichi
- Division of Cardiology, Yokohama City University Medical Center
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- Takano Keiko
- Division of Cardiology, Yokohama City University Medical Center
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- Nakayama Naoki
- Division of Cardiology, Yokohama City University Medical Center
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- Kataoka Shunsuke
- Division of Cardiology, Yokohama City University Medical Center
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- Ebina Toshiaki
- Division of Cardiology, Yokohama City University Medical Center
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- Kosuge Masami
- Division of Cardiology, Yokohama City University Medical Center
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- Hibi Kiyoshi
- Division of Cardiology, Yokohama City University Medical Center
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- Tsukahara Kengo
- Division of Cardiology, Yokohama City University Medical Center
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- Iwahashi Noriaki
- Division of Cardiology, Yokohama City University Medical Center
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- Endo Mitsuaki
- Division of Cardiology, Yokohama City University Medical Center
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- Maejima Nobuhiko
- Division of Cardiology, Yokohama City University Medical Center
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- Shinohara Kentaro
- Department of Orthopedic Surgery, Yokohama City University Medical Center
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- Taki Naoya
- Department of Orthopedic Surgery, Yokohama City University Medical Center
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- Mitsugi Naoto
- Department of Orthopedic Surgery, Yokohama City University Medical Center
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- Taguri Masataka
- Department of Biostatistics and Epidemiology, Yokohama City University Graduate School of Medicine and University Medical Center
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- Sugiyama Seigo
- Jinnouchi Hospital Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
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- Ogawa Hisao
- Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University
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- Umemura Satoshi
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine
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- Kimura Kazuo
- Division of Cardiology, Yokohama City University Medical Center
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Background: Venous thromboembolism (VTE) is a common and sometimes lethal postoperative complication of arthroplasty. Endothelial dysfunction is important in the pathogenesis of thrombus formation. Reactive hyperemia-peripheral arterial tonometry (RH-PAT) can noninvasively evaluate endothelial function. This study investigated the predictive value of RH-PAT for deep vein thrombosis (DVT) after lower limb arthroplasty. Methods and Results: A prospective observational study of 126 osteoarthritic patients who underwent total knee arthroplasty (TKA) or hip arthroplasty (THA) was conducted. The RH-PAT index (RHI) was measured on the day before surgery, and presence of DVT was checked by ultrasonography or phlebography before and after surgery. Following arthroplasty, DVT was diagnosed in 51 patients (40.5%). RHI in the DVT group (0.58±0.25) was significantly lower than in the non-DVT group (0.71±0.25, P=0.004). RHI was a significant and independent predictor of postoperative DVT in multivariate logistic regression analyses and improved a net reclassification index (23.8%, P=0.022). Subgroup analyses according to operation site with adjustment for Qthrombosis score demonstrated that RHI significantly predicted postoperative DVT in the THA group (odds ratio per 0.1, 0.77; 95% confidence interval 0.60–0.98; P=0.03), but did not reach statistical significance in the TKA group. Conclusions: Low RHI was significantly associated with DVT after lower limb arthroplasty. Endothelial dysfunction, as assessed by RH-PAT, is potentially useful for identifying patients at high risk for VTE especially after THA. (Circ J 2014; 78: 1723–1732)<br>
収録刊行物
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- Circulation Journal
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Circulation Journal 78 (7), 1723-1732, 2014
一般社団法人 日本循環器学会
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詳細情報 詳細情報について
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- CRID
- 1390001205106426624
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- NII論文ID
- 130003391143
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- NII書誌ID
- AA11591968
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- COI
- 1:STN:280:DC%2BC2cnntVymsQ%3D%3D
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- ISSN
- 13474820
- 13469843
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- NDL書誌ID
- 025533837
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- PubMed
- 24770356
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- 本文言語コード
- en
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- データソース種別
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- JaLC
- NDL
- Crossref
- PubMed
- CiNii Articles
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- 使用不可