Rivaroxaban versus aspirin in prevention of venous thromboembolism following total joint arthroplasty or hip fracture surgery: a meta-analysis
Research article published in Journal of orthopaedic surgery and research (2021)
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.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Summary
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Why This Matters for Hirudotherapy
This meta-analysis pooled 7 studies and 5133 patients to compare rivaroxaban with aspirin for preventing venous thromboembolism after total hip or knee arthroplasty or hip fracture surgery, and found no significant difference between the two agents in VTE, major bleeding, or all-cause mortality, while rivaroxaban significantly increased nonmajor bleeding (RR 1.29, 95% CI 1.05 to 1.58). For ASH it informs the wider anticoagulation and post-surgical thromboprophylaxis evidence base that frames how clinicians weigh bleeding versus clotting risk, the same balance central to leech therapy, where the leech secretome produces a local anticoagulant and bleeding effect. The caveat is that this study evaluates systemic oral anticoagulant drugs, not leech therapy or any leech-derived compound, and although a meta-analysis is a higher tier of synthesis, its conclusions apply to orthopedic VTE prophylaxis rather than to hirudotherapy outcomes.
Citation
Rivaroxaban versus aspirin in prevention of venous thromboembolism following total joint arthroplasty or hip fracture surgery: a meta-analysis.
Hu et al. · Journal of orthopaedic surgery and research, 2021
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