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Review
. 2021 Feb 13;16(1):135.
doi: 10.1186/s13018-021-02274-z.

Rivaroxaban versus aspirin in prevention of venous thromboembolism following total joint arthroplasty or hip fracture surgery: a meta-analysis

Bangsheng Hu #  1 , Lianxiang Jiang #  1 , Haixia Tang  2 , Meizhu Hu  1 , Jun Yu  1 , Zeping Dai  3
Affiliations
Review

Rivaroxaban versus aspirin in prevention of venous thromboembolism following total joint arthroplasty or hip fracture surgery: a meta-analysis

Bangsheng Hu et al. J Orthop Surg Res. .

Abstract

Objective: To evaluates the efficacy and safety of rivaroxaban versus aspirin in prevention of venous thromboembolism (VTE) following total hip (THA) or knee arthroplasty (TKA) or hip fracture surgery.

Methods: Major databases were systematically searched for all relevant studies published in English up to October 2020. The meta-analysis was conducted using RevMan 5.3 software.

Results: In total, 7 studies were retrieved which contained 5133 patients. Among these patients, 2605 patients (50.8%) received rivaroxaban, whereas 2528 patients (49.2%) received aspirin. There were no statistical difference between aspirin and rivaroxaban for reducing VTE (RR = 0.75, 95% CI 0.50-1.11, I2 = 36%, p = 0.15), major bleeding (RR = 0.94, 95% CI 0.45-2.37, I2 = 21%, p = 0.95), and all-cause mortality (RR = 0.88, 95% CI 0.12-6.44, I2 = 0%, p = 0.90) between the two groups. Compared with aspirin, rivaroxaban significantly increased nonmajor bleeding (RR = 1.29, 95% CI 1.05-1.58, I2 = 0%, p = 0.02).

Conclusion: There was no significant difference between aspirin and rivaroxaban in prevention of venous thromboembolism following total joint arthroplasty or hip fracture surgery. Aspirin may be an effective, safe, convenient, and cheap alternative for prevention of VTE. Further large randomized studies are required to confirm these findings.

Keywords: Arthroplasty; Aspirin; Meta-analysis; Rivaroxaban; Thromboembolism.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of the selection process
Fig. 2
Fig. 2
Forest plot of venous thromboembolism (VTE)
Fig. 3
Fig. 3
Forest plot of major bleeding
Fig. 4
Fig. 4
Forest plot of nonmajor bleeding
Fig. 5
Fig. 5
Forest plot of all-cause mortality
See this image and copyright information in PMC

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References

    1. Piovella F, Wang CJ, Lu H, Lee K, Lee LH, Lee WC, et al. Deep-vein thrombosis rates after major orthopedic surgery in Asia. An epidemiological study based on postoperative screening with centrally adjudicated bilateral venography. J Thromb Haemost. 2005;3(12):2664–2670. doi: 10.1111/j.1538-7836.2005.01621.x. - DOI - PubMed
    1. Memtsoudis SG, Pumberger M, Ma Y, Chiu YL, Fritsch G, Gerner P, et al. Epidemiology and risk factors for perioperative mortality after total hip and knee arthroplasty. J Orthop Res. 2012;30(11):1811–1821. doi: 10.1002/jor.22139. - DOI - PMC - PubMed
    1. Yu HT, Dylan ML, Lin J, Dubois RW. Hospitals’ compliance with prophylaxis guidelines for venous thromboembolism. Am J Health-System Pharm. 2007;64(1):69–76. doi: 10.2146/ajhp060115. - DOI - PubMed
    1. Anderson DR, Dunbar M, Murnaghan J, Kahn SR, Gross P, Forsythe M, et al. Aspirin or rivaroxaban for VTE prophylaxis after hip or knee arthroplasty. N Engl J Med. 2018;378(8):699–707. doi: 10.1056/NEJMoa1712746. - DOI - PubMed
    1. Chung I, Lip GY. Virchow's triad revisited: blood constituents. Pathophysiol Haemost Thromb. 2003;33:449–454. doi: 10.1159/000083844. - DOI - PubMed

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