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.
Resumen
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Por qué esto importa para la hirudoterapia
Este metaanálisis agrupó 7 estudios y 5133 pacientes para comparar la rivaroxabán con la aspirina para prevenir la tromboembolia venosa después de una artroplastia total de cadera o rodilla o de una cirugía de fractura de cadera, y no encontró ninguna diferencia significativa entre los dos agentes en cuanto a VTE, sangrado mayor o mortalidad por todas las causas, mientras que la rivaroxabán aumentó significativamente el sangrado no mayor (RR 1,29, IC del 95%: 1,05 a 1,58). Para ASH, informa la base de evidencia más amplia sobre anticoagulación y tromboprofilaxis posquirúrgica que delinea cómo los clínicos ponderan el riesgo de sangrado frente al de coagulación, el mismo equilibrio que es central a la terapia con sanguijuelas, donde el secretoma de la sanguijuela produce un efecto anticoagulante local y de sangrado. La advertencia es que este estudio evalúa fármacos anticoagulantes orales sistémicos, no la terapia con sanguijuelas ni ningún compuesto derivado de sanguijuelas, y aunque un metaanálisis es un nivel superior de síntesis, sus conclusiones se aplican a la tromboprofilaxis de VTE ortopédica en lugar de a los resultados de la hirudoterapia.
Citación
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
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: June 18, 2026