A randomized trial tested once-daily thromboprophylaxis with aspirin or rivaroxaban for the first 5 days after total hip or total knee arthroplasty, followed by aspirin alone.Aspirin alone came out noninferior for preventing symptomatic venous thromboembolism, with no clinically relevant difference in bleeding events between groups.The trial supports an aspirin-alone strategy for people at standard risk, potentially indicating a cheaper and simpler approach to prophylaxis against blood clots.
An aspirin-only approach to postoperative prophylaxis after arthroplasty was as effective and safe as upfront rivaroxaban (Xarelto), according to the EPCAT III randomized trial.
Aspirin-only prophylaxis met noninferiority criteria for preventing symptomatic venous thromboembolism (VTE), compared with rivaroxaban then aspirin after total hip or total knee arthroplasty, reported investigators led by Sudeep Shivakumar, MD, of Dalhousie University and Nova Scotia Health Authority in Halifax.
Following arthroplasty, the incidence of symptomatic VTE over 90 days -- counting proximal deep vein thrombosis or pulmonary embolism -- reached 0.48% with aspirin alone and a similar 0.45% with rivaroxaban-aspirin (risk difference 0.02, 95% CI -0.34 to 0.39).
