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연세대학교 의과대학 Yonsei Medical Journal Yonsei Medical Journal 제60권 제7호
발행연도
2019.1
수록면
626 - 632 (7page)

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Purpose: To compare the effect of apixaban and low molecular weight heparin (LMWH) in the prevention and treatment of deepvenous thrombosis (DVT) after total knee arthroplasty in older adult patients. Materials and Methods: A total of 220 patients (average age of 67.8±6.4 years) undergoing total knee arthroplasty were randomlyselected as research subjects and were divided into apixaban and LMWH groups (110 in each group). Results: The incidence of DVT was lower in the apixaban group than in the LMWH group (5.5% vs. 20.0%, p=0.001). Activatedpartial thromboplastin times (35.2±3.6 sec vs. 33.7±2.2 sec, p=0.010; 37.8±4.6 sec vs. 34.1±3.2 sec, p<0.001; 39.6±5.1 sec vs. 35.7±3.0sec, p=0.032) and prothrombin times (14.0±1.0 sec vs. 12.8±0.9 sec, p<0.001; 14.5±1.2 sec vs. 13.0±1.1 sec, p<0.001; 15.3±1.4 sec vs. 13.2±1.3 sec, p=0.009) in the apixaban group at 1 week after surgery, 3 weeks after surgery, and the end of treatment were higherthan those in the LMWH group. Platelet and fibrinogen levels in the apixaban group were lower than those of the LMWH group. Also, capillary plasma viscosity and erythrocyte aggregation in the apixaban group at 1 week after surgery, 3 weeks after surgery,and the end of treatment were lower than those in the LMWH group. Conclusion: Apixaban, which elicits fewer adverse reactions and is safer than LMWH, exhibited better effects in the preventionand treatment of DVT after total knee arthroplasty in older adults.

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