Elevated soluble platelet glycoprotein VI is a useful marker for DVT in postoperative patients treated with edoxaban

Abstract

Prevention of deep vein thrombosis (DVT) is important in patients undergoing major orthopedic surgery. Although the detection of an elevated D-dimer level is useful for predicting DVT, it is not efficacious in postoperative patients being treated with anti-Xa agents. The soluble platelet glycoprotein VI (sGPVI) level is a marker of activated platelets, but not bleeding. Therefore, sGPVI levels are usually examined as a predictor of DVT in such patients. In the present study, 83 orthopedic patients were treated with 30 mg of edoxaban for prophylaxis of DVT. Fourteen patients developed DVT and 17 patients discontinued the prophylaxis due to decreased hemoglobin levels. Plasma levels of sGPVI in the patients were significantly higher after surgery than before surgery. On day 1, the sGPVI levels increased, while the platelet counts decreased. There were no significant differences in D-dimer, soluble fibrin, or FDP levels in orthopedic patients with and without DVT before surgery and on days 1, 4, and 8. Plasma sGPVI levels were significantly higher in the patients with DVT than in those without DVT on days 1 and 4. Plasma levels of D-dimer were significantly higher in patients with withdrawal than in those without. However, there were no significant differences in sGPVI levels between those with and without withdrawal. As D-dimer levels are known to increase in patients with withdrawal, this parameter is not useful for evaluating the risk of DVT in these patients. In contrast, the sGPVI level is not increased in those with withdrawal and may therefore be useful for evaluating the risk of DVT in postoperative patients treated with an anticoagulant.

Platelet Activation Assessed by Glycoprotein VI/Platelet Ratio Is Associated With Portal Vein Thrombosis After Hepatectomy and Splenectomy in Patients With Liver Cirrhosis

“…But Aota et al reported that GPVI level was significantly higher in the patients with DVT than in those without DVT, and they suggested that the activation of platelet was important in venous thrombosis formation. 22 Therefore, the activation of the platelet assessed by sGPVI is also considered to affect PVT formation. In present study, the incidences of PVT in both Sx group and Hx group were significantly higher in patients with LC than in patients with non-LC.…”

“…18 According to the previous literatures, sGPVI levels are elevated in the diseases caused by the thrombus and coagulation disorder, such as acute coronary syndrome (ACS), 19 stroke, 20 disseminated intravascular coagulation, 21 and deep vein thrombosis (DVT). 22 Recently, Egan et al reported that sGPVI levels were significantly higher in patients with LC than those in healthy patients. 23 To the best of our knowledge, there have been no reports on the relationship between sGPVI levels and PVT.…”

Elevated Soluble Platelet Glycoprotein VI Levels in Patients After Living Donor Liver Transplantation

“…Thrombocytopenia is commonly associated with LDLT and many complications of LDLT, suggesting that it is important to know the degree of platelet activation in LDLT patients with thrombocytopenia. The plasma sGPVI levels have been reported to significantly increase in patients with thrombosis during the postoperative period 36 and those with DIC 35 or TMA, thus suggesting that the plasma sGPVI levels increase in a thrombotic state, which thus activates platelets. 30 In a cynomolgus monkey model of lipopolysaccharide-induced thrombocytopenia, the change in sGPVI was more pronounced than the existing platelet activation biomarker, soluble P-selectin.…”

Platelets Activation and Liver Transplantation

“…Several groups have reported that sGPVI is a useful biomarker of diseases caused by platelet activation, such as acute coronary syndrome and stroke [36,37]. The plasma sGPVI levels have been reported to be significantly increased in patients with thrombosis during the postoperative period [38] and in patients with DIC or TMA [39], suggesting that the plasma sGPVI levels increase in a thrombotic state, which activates platelets (Tables 2 and 3). …”