Efficacy and safety of aspirin and rivaroxaban for venous thromboembolism prophylaxis after total hip or knee arthroplasty: A protocol for meta-analysis.

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Tytuł:: Efficacy and safety of aspirin and rivaroxaban for venous thromboembolism prophylaxis after total hip or knee arthroplasty: A protocol for meta-analysis.
Autorzy:: Le G; Division of Traumatic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning.
Yang C; Department of Orthopedics, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.
Zhang M; Department of Orthopedics, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.
Xi L; Department of Orthopedics, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.
Luo H; Department of Orthopedics, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.
Tang J; Department of Orthopedics, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, Guangxi, China.
Zhao J; Division of Traumatic Surgery, First Affiliated Hospital of Guangxi Medical University, Nanning.
Źródło:: Medicine [Medicine (Baltimore)] 2020 Dec 04; Vol. 99 (49), pp. e23055.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
MeSH Terms:: Anticoagulants/*administration & dosage
Arthroplasty, Replacement, Knee/*methods
Aspirin/*administration & dosage
Rivaroxaban/*administration & dosage
Venous Thromboembolism/*prevention & control
Anticoagulants/adverse effects ; Aspirin/adverse effects ; Blood Transfusion/statistics & numerical data ; Hemorrhage/chemically induced ; Humans ; Pulmonary Embolism/prevention & control ; Research Design ; Rivaroxaban/adverse effects ; Surgical Wound Infection/epidemiology ; Venous Thrombosis/prevention & control ; Meta-Analysis as Topic ; Systematic Review as Topic
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Substance Nomenclature:: 0 (Anticoagulants)
9NDF7JZ4M3 (Rivaroxaban)
R16CO5Y76E (Aspirin)
Entry Date(s):: Date Created: 20201208 Date Completed: 20201223 Latest Revision: 20230905
Update Code:: 20240104
PubMed Central ID:: PMC7717737
DOI:: 10.1097/MD.0000000000023055
PMID:: 33285683
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Background: The purpose of this meta-analysis is to compare the efficacy and safety of aspirin and rivaroxaban in the prevention of venous thromboembolism (VTE) following either total knee arthroplasty or total hip arthroplasty.
Methods: A comprehensive literature search of several electronic databases (PubMed, Embase, and Web of Science) was conducted to identify relevant studies. Outcomes of interest included VTE rate, deep vein thrombosis (DVT) rate, pulmonary embolism rate, major bleeding events, mortality rate, blood transfusion, and wound complication. Risk ratio (RR) with 95% confidence intervals (95%CIs) were calculated using a fixed-effects model or random-effects model.
Results: A total of 8 studies with 97,677 patients met the inclusion criteria and were included in this meta-analysis. Compared with rivaroxaban, aspirin had a significantly higher incidence of DVT (RR = 1.48, 95%CI: 1.27, 1.72; P < .001), and decreased risk of blood transfusion (RR = 0.94, 95%CI: 0.93, 0.94; P < .001). However, there were no significant differences between the 2 drugs in terms of total VTE rate (RR = 1.39%, 95%CI: 0.94, 2.05; P = .101), pulmonary embolism rate (RR = 1.64, 95%CI: 0.92, 2.92; P = .094), mortality rate (RR = 1.13, 95%CI: 0.15, 8.27; P = .907), major bleeding (RR = 1.00, 95%CI: 0.44, 2.27; P = .995), and wound complication rate (RR = 0.37, 95%CI: 0.07, 1.87; P = .229).
Conclusion: Our results suggested that aspirin and rivaroxaban offered similar effect in the prevention of VTE after total knee arthroplasty or total hip arthroplasty. However, rivaroxaban seemed to have better effect than aspirin in reducing the risk of DVT, and aspirin was safer than rivaroxaban in decreasing the blood transfusion rate.

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