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. 2021 Mar 20;33(1):10.
doi: 10.1186/s43019-021-00093-4.

Which orally administered antithrombotic agent is most effective for preventing venous thromboembolism after total knee arthroplasty? A propensity score-matching analysis

Seonpyo Jang #  1   2 , Woo Cheol Shin #  2 , Min Ku Song  3 , Hyuk-Soo Han  1   2 , Myung Chul Lee  1   2 , Du Hyun Ro  4   5
Affiliations

Which orally administered antithrombotic agent is most effective for preventing venous thromboembolism after total knee arthroplasty? A propensity score-matching analysis

Seonpyo Jang et al. Knee Surg Relat Res. .

Abstract

Purpose: Even today, total knee arthroplasty (TKA) is associated with venous thromboembolism (VTE). The purpose of our study is to report the incidence of postoperative VTE and to compare the efficacy of commonly used orally administered antithrombotic agents.

Materials and methods: Seven hundred ad ninety-nine patients who underwent primary TKA were retrospectively reviewed. The patients were prescribed one of three antithrombotic agents: aspirin (n = 168), rivaroxaban (n = 117), or apixaban (n = 514). Before surgery, patient demographics and risk factors were matched via propensity scoring. After surgery, all three groups took the agent for 7 days and underwent ultrasonography to check for VTE.

Results: The overall incidence of postoperative VTE was 15.4% (123/799). Only one patient developed symptomatic VTE. Female sex and staged bilateral TKA were risk factors for postoperative VTE. The postoperative VTE rates in the aspirin, rivaroxaban, and apixaban groups were 16.2%, 6.0%, and 17.1%, respectively, significantly lower in the rivaroxaban group (p < 0.02). The majority of VTEs in all three groups were calf-vein thromboses.

Conclusions: All agents showed enough efficacy as antithrombotic agents. Considering that aspirin is inexpensive, aspirin is a cost-effective option for preventing postoperative VTE.

Keywords: Antithrombotic agent; Apixaban; Aspirin; Rivaroxaban; Total knee arthroplasty; Venous thromboembolism.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of reasons for exclusion and propensity score-matching
See this image and copyright information in PMC

References

    1. Rahman MM, Kopec JA, Cibere J, Goldsmith CH, Anis AH. The relationship between osteoarthritis and cardiovascular disease in a population health survey: a cross-sectional study. BMJ Open. 2013;3(5):e002624. doi: 10.1136/bmjopen-2013-002624. - DOI - PMC - PubMed
    1. Gadermann AM, Alonso J, Vilagut G, Zaslavsky AM, Kessler RC. Comorbidity and disease burden in the National Comorbidity Survey Replication (NCS-R) Depress Anxiety. 2012;29(9):797–806. doi: 10.1002/da.21924. - DOI - PMC - PubMed
    1. Mantilla CB, Horlocker TT, Schroeder DR, Berry DJ, Brown DL. Frequency of myocardial infarction, pulmonary embolism, deep venous thrombosis, and death following primary hip or knee arthroplasty. Anesthesiology. 2002;96(5):1140–1146. doi: 10.1097/00000542-200205000-00017. - DOI - PubMed
    1. Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am. 2007;89(4):780–785. doi: 10.2106/00004623-200704000-00012. - DOI - PubMed
    1. Prandoni P, Lensing AW, Prins MR. Long-term outcomes after deep venous thrombosis of the lower extremities. Vasc Med. 1998;3(1):57–60. doi: 10.1177/1358836X9800300112. - DOI - PubMed

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