Rivaroxaban and Acetylsalicylic Acid for Prevention of Venous Thromboembolism Following Total Knee Arthroplasty in Korean Patients
- Author:
Kyu Sung CHUNG
1
;
Tae Yang SHIN
;
Sang Hoon PARK
;
Hyuck KIM
;
Choong Hyeok CHOI
Author Information
- Publication Type:Original Article
- Keywords: Knee; Arthroplasty; Venous thromboembolism; Rivaroxaban; Acetylsalicylic acid
- MeSH: Administration, Oral; Arthroplasty; Arthroplasty, Replacement, Knee; Aspirin; Chemoprevention; Follow-Up Studies; Heparin, Low-Molecular-Weight; Humans; Incidence; Injections, Subcutaneous; Knee; Multidetector Computed Tomography; Pulmonary Embolism; Rivaroxaban; Venous Thromboembolism; Venous Thrombosis
- From:The Journal of Korean Knee Society 2018;30(3):247-254
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: To investigate the incidence of venous thromboembolism (VTE) after total knee arthroplasty (TKA) with chemoprophylaxis using acetylsalicylic acid (AA) or rivaroxaban in Korean patients. MATERIALS AND METHODS: Between May 2011 and November 2013, 268 TKA patients (330 cases) were randomly allocated to 3 groups (group A: subcutaneous injection of 5,000 IU low-molecular-weight heparin for 2 days followed by oral administration of 100 mg AA for 5 days; group X7: oral administration of 10mg rivaroxaban for 7 days; and group X10: oral administration of 10 mg rivaroxaban for 10 days). Multidetector-row computed tomography (MDCT) was performed at 10 days and 3 months postoperatively to evaluate VTE changes. RESULTS: The VTE incidence was 38.2%, 20.0%, and 10.0% in groups A, X7, and X10, respectively (p < 0.001). Pulmonary embolism (PE) was identified in 19.1%, 10.0%, and 2.7% in groups A, X7, and X10, respectively (p < 0.001). Proximal or symptomatic deep vein thrombosis (DVT) occurred primarily in group A, but the incidence was not significantly different among groups. On follow-up MDCT, PE was resolved completely with treatment in 29/30 (96.7%), and so was asymptomatic distal DVT in 24/27 (88.8%) without treatment. CONCLUSIONS: Rivaroxaban had a lower incidence of overall VTE than AA, but no difference was observed in symptomatic VTE. The 10-day course of rivaroxaban had a lower incidence of overall VTE than the 7-day course.
