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International Angiology 1999 March;18(1):65-9

Copyright © 2000 EDIZIONI MINERVA MEDICA

lingua: Inglese

Thrombocytosis after prophylactic administration of enoxaparin: unexpected findings in a Polish prospective multicenter trial on the efficacy and safety of enoxaparin in the prevention of postoperative thromboembolism

Ziaja K., Simka M., Krupowies A., Dugaj M., Ludyga T.

From the First Department of General & Vascular Surgery, Silesian Medical Academy, Katowice, Poland


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Background. Heparin-relat­ed throm­bo­cy­to­pe­nia is a com­mon com­pli­ca­tion of hep­ar­in admin­is­tra­tion and there­fore plate­let count was mon­i­tored in our study.
Methods. Experimental ­design: Prospective mul­ti­cen­tre study. Setting: 14 Departments of General, Thoracic or Ortho-pedic Surgery, Poland. Patients: 290 ­patients—150 gen­er­al or tho­rac­ic sur­gery ­patients aged above 40 years, and 140 ortho­pae­dic sur­gery ­patients aged ­between 18 and 60 years. Interventions: All ­patients ­received 20 mg (gen­er­al and tho­rac­ic sur­gery) or 40 mg of enox­ap­ar­in (ortho­pae­dic sur­gery) once daily sub­cu­ta­ne­ous­ly both ­before sur­gery and dur­ing post­op­er­a­tive immo­bil­isa­tion. Measures: Platelet count was eval­u­at­ed prior to sur­gery and on the 5th, 7th, 11th and 15th day fol­low­ing the oper­a­tion.
Results. There was nei­ther throm­bo­cy­to­pe­nia nor hep­ar­in-­induced throm­bo­sis. Paradoxically, post­op­er­a­tive plate­let count in most cases ­increased slight­ly but sta­tis­ti­cal­ly sig­nif­i­cant­ly, but in some how­ev­er, even above 600 G/l, nev­er­the­less in these ­patients no throm­bot­ic com­pli­ca­tions ­occurred. Postoperative throm­bo­cy­to­sis was great­er in ­patients with neo­plasms as well as those with exces­sive per­i­op­er­a­tive blood loss and trans­fu­sions.
Conclusions. As plate­let count was not the main topic of our study, the pre­sent­ed data ­should be regard­ed only as pre­lim­i­nary. Further inves­ti­ga­tions to ­resolve the cause of the ­observed phe­nom­e­non of throm­bo­cy­to­sis are there­fore nec­es­sary.

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