Global coagulation tests in pharmacological prophylaxis of venous thromboembolism in patients with prostate cancer after radical prostatectomy

A significant problem in oncology is venous thromboembolic (VTE) complications. Thrombosis detected in a patient with a malignant neoplasm of the prostate gland increases the risk of death by 3.4 times compared to patients without it. The prevalence of tumors in this localization, the use of an integrated approach to treatment, including before surgery, the risk of hemorrhagic complications, age and concomitant diseases of patients make the problem of the effectiveness and safety of thrombosis prevention relevant. Objective. Determine the most appropriate coagulation test to monitor the effectiveness and safety of pharmacological prevention of VTE in patients with malignant neoplasm of the prostate gland after radical prostatectomy. Material and methods. The study included 44 patients diagnosed with prostate cancer. All patients underwent radical prostatectomy. Pharmacological prevention of VTE was performed with low-molecular-weight heparin (LWH) — calcium nadroparin in a standard dose, according to the recommendations of the American Society of Clinical Oncology (ASCO). Blood was collected for laboratory tests at 3 control points: the day of hospitalization, after surgery before the first administration of LWH, at the peak of the LWH effect 3—3.5 hours after subcutaneous administration. Results. The K interval of the thromboelastogram changed more frequently at all control points of the study. The maximum amplitude allowed us to identify a tendency to hypercoagulation before the start of pharmacological prophylaxis. The clot growth rate of the thrombodynamics test showed the most pronounced changes depending on the stage of treatment. The advantage of the thrombodynamics test is the known range of LMWH effectiveness, which makes this method more optimal and convenient to use. Conclusion. Global coagulation tests during pharmacological prophylaxis of thrombosis in the postoperative period were more sensitive to changes in the state of hemostasis compared to activated partial thromboplastin time.