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

Journal of Orthopaedic Surgery and Research

Jun Yu¹  Zeping Dai¹  Meizhu Hu¹  Bangsheng Hu¹  Lianxiang Jiang¹  Haixia Tang² 

[1] Department of Anesthesiology, The First Affiliated Hospital of Wannan Medical College, No.2, West Road of Zheshan, 241000, Wuhu, Anhui, China;Department of Cardiology, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China;

关键词: Rivaroxaban;    Aspirin;    Thromboembolism;    Arthroplasty;    Meta-analysis;   

DOI  :  10.1186/s13018-021-02274-z

来源: Springer

【 摘 要 】

ObjectiveTo 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.MethodsMajor 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.ResultsIn 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).ConclusionThere 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.

【 授权许可】

CC BY