Clinical outcomes and risk factors of thromboprophylaxis with rivaroxaban versus aspirin in patients undergoing hip arthroplasty in low‐incidence population: A nationwide study in Korea

Abstract

Purpose We aimed to evaluate the efficacy and safety of rivaroxaban in thromboprophylaxis compared with those of aspirin in real‐world patients who underwent hip arthroplasty using nationwide claims data. Methods Patients aged more than or equal to 18 years with at least one hip arthroplasty including total and partial hip replacements and hip replacement revisions during July 2009 to June 2013 were identified from the Health Insurance Review and Assessment (HIRA) database. The study outcome was incidence rate of thromboembolic events and anticoagulation‐related major bleeding within 90 days of hip arthroplasty. Results The incidence of overall venous thromboembolism (VTE) within 90‐day postsurgery was significantly higher in the aspirin cohort than it was in the rivaroxaban cohorts. Bleeding events associated with pharmacological thromboprophylaxis in patients who received rivaroxaban were not significantly different from that in aspirin‐treated patients. In aspirin cohorts, 65.7% of patients received less than 3‐week treatment while about half received a less than 14‐day treatment, and 31.7% received more than 3‐week treatment in the rivaroxaban cohort. Conclusions This study demonstrates that rivaroxaban was more effective in preventing VTE following hip arthroplasty without raising bleeding risks in clinical settings. Age more than or equal to 80 years, women, and a history of thromboembolism were the risk factors of VTE incidence.

Current status survey of the extramural hospital management of venous thromboembolism after total hip and knee arthroplasty in China

“…However, in terms of DVT, aspirin showed an increased risk compared with rivaroxaban. Consistent with most of the published studies [25][26][27], the results of anticoagulant measures after discharge indicated that new oral anticoagulants are mainly used outside the hospital. This may be due to the outstanding advantages of new anticoagulants, such as stable pharmacokinetics, fixed doses, and good safety.…”