Comparison of Efficacy of Low Molecular Weight Heparin Versus Oral Anticoagulant in Indian Population for Prevention of Deep Vein Thrombosis in Total Knee Replacement
Yogeshwaran Elumalai*, Dorai Kumar R, Vishal Anand, Mohan Choudary and Anandha Prabu V
Sri Ramachandra university medical college, Tamil Nadu, India
- *Corresponding Author:
- Yogeshwaran Elumalai
Sri Ramachandra university medical college
Tamil Nadu, India
E-mail: [email protected]
Received Date: November 22, 2014; Accepted Date: January 03, 2015; Published Date: January 07, 2015
Citation: Elumalai Y, Dorai Kumar R, Anand V, Choudary M, Anandha Prabu V (2015) Comparison of Efficacy of Low Molecular Weight Heparin Versus Oral Anticoagulant in Indian Population for Prevention of Deep Vein Thrombosis in Total Knee Replacement. Orthop Muscul Syst 4:181. doi: 10.4172/2161-0533.1000181
Copyright: © 2015 Elumalai Y, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Nearly 50% of patients who undergo TKR develop symptomatic/ asymptomatic DVT without prophylaxis. Since LMWH is costly, subcutaneous injection and inconvenience to patient, Oral anticoagulant is used as alternative. It is a prospective study where patients were observed for 15 days, following TKR. The effectiveness of LMWH Vs Oral anticoagulant in Indian population was done comparing 100 patients who underwent TKR. Inclusion criteria - age more than 18 years, under any anesthesia, Indian origin. Exclusion criteria were head injury, abdominal injury,poly trauma, history of DVT, indwelling epidural catheter. Oral anticoagulant used in the study Dabigatran etexilate 220 mg OD or Apixaban 2.5 mg BD for 15 days. Patient was done colour doppler pre-operatively, POD-(3-5) and (13-15). In 100 patients, 25 patients were given Dabigatran, 25 were given Apixaban and 50 were given LWMH. The absolute risk difference - 1.1% in favour of oral anticoagulant. Thus oral anticoagulants was non-inferior to LMWH (P<0.0001). Major bleeding occurred in 2 patients in oral anticoagulant group but none were fatal or required discontinuation of drug. The study showed both oral anticoagulants given for 15 days were as effective as LMWH for prevention of DVT in TKR. Oral anticoagulant proved to be non-inferior to LMWH. Oral anti-coagulant is effective, well tolerated, low rate of bleeding, no evidence of elevated liver enzymes or acute coronary events when compared to LMWH.