Rivaroxaban versus Aspirin in Prevention of Venous Thromboembolism: A Meta-Analysis of 9 Randomized Controlled Trials comprising 7,656 Patients

Abstract

Aim This article evaluates the preventive effects of rivaroxaban versus aspirin on venous thromboembolism (VTE) through meta-analysis of recent randomized controlled trials (RCTs). Methods RCTs were retrieved from medical literature databases. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated to compare the primary and safety endpoints. Results In total, 9 trials (11 trial comparisons) were retrieved which contained 7,656 patients. Among these patients, 4,383 patients (57.2%) received rivaroxaban, whereas 3,273 patients (42.8%) received aspirin. Compared with aspirin, rivaroxaban significantly reduced VTE (1.3% vs. 3.5%) (RR: 0.36, 95% CI, 0.26–0.48, I 2 = 27.9%), but significantly increased nonmajor bleeding (11.5% vs. 7.5%) (RR: 1.28, 95% CI, 1.13–1.44, I 2 = 38.6%). There were no significant differences in the all-cause mortality (0.3% vs. 0.3%) (RR: 0.75, 95% CI, 0.35–1.61, I 2 = 32.0%) and major bleeding (0.3% vs. 0.4%) (RR: 0.81, 95% CI, 0.42–1.55, I 2 = 33.7%) between the two groups. Conclusion This meta-analysis indicated that rivaroxaban can significantly reduce the incidence of VTE when compared with aspirin. The preventive effect of rivaroxaban on VTE was more potent than that of aspirin. However, rivaroxaban had some negative side effects to patients such as nonmajor bleeding compared to aspirin.

Discontinuation of oral anticoagulant use among nursing home residents with atrial fibrillation before hospice enrollment

“…We also tracked the presence of any hospitalizations with inpatient surgery in the past 6 months, as acute events arising in hospitalizations that may affect clinical decision making. From the MDS, we included a history of recent falls (J1800), rejected evaluation or care (E0800), cancer diagnosis (I0100), cognitive impairment based on the Cognitive Function Scale 25 and self-performance of activities of daily living (ADLs) as (low functional dependency [0-7], mild functional dependency [8][9][10][11][12][13][14], moderate functional dependency [15][16][17][18][19][20][21], and high functional dependency [22][23][24][25][26][27][28]). 26 We created a categorical variable that indicated the index date year.…”

“…Anticoagulants are highly effective in reducing the risk of cardioembolic stroke, systemic embolism, and venous thromboembolic disease and are recommended for high‐risk patients with atrial fibrillation 1–11 . Among adults 75 years and older, anticoagulation has been associated with a significantly decreased risk of stroke and a comparable risk of serious bleeding compared with aspirin 12 .…”

“…Anticoagulants are highly effective in reducing the risk of cardioembolic stroke, systemic embolism, and venous thromboembolic disease and are recommended for highrisk patients with atrial fibrillation. [1][2][3][4][5][6][7][8][9][10][11] Among adults 75 years and older, anticoagulation has been associated with a significantly decreased risk of stroke and a comparable risk of serious bleeding compared with aspirin. 12 Despite strong evidence of effectiveness, and acceptable safety among older adults with atrial fibrillation, many of these individuals do not receive oral anticoagulants (OACs).…”

Identification of thrombotic biomarkers in orthopedic surgery patients by plasma proteomics

“…More than 10% incidence of VTE has been reported after knee or hip joint replacement surgery [ 7 ]. And PE contributes to a mortality rate of 70% among patients [ 8 ]. Unfortunately, there may be no obvious signs of thrombosis, and thrombosis can occur at any age and at any time, seriously threatening the life and health of patients.…”

New Oral Anticoagulants for Venous Thromboembolism Prophylaxis in Total Hip and Knee Arthroplasty: A Systematic Review and Network Meta-Analysis

“…A more than 10% incidence of venous thromboembolism (VTE) [deep vein thrombosis (DVT) and pulmonary embolism (PE)] has been reported after knee or hip arthroplasty ( Falck-Ytter et al, 2012 ). The PE caused by undiagnosed or untreated DVT has substantial health care costs, and seriously affects the functionality of patients and even contributes to a mortality rate of 70% among patients ( Strandness et al, 1983 ; Xie et al, 2019 ).…”