Antiplatelet agents showed no significant difference compared to anticoagulants in preventing VTE after joint arthroplasty (RR 1.08; 95% CI 0.81-1.44).
Meta-Analysis (n=30,290)
Do antiplatelet agents prevent VTE as effectively as anticoagulants in adults undergoing joint arthroplasty?
Antiplatelet agents are as effective as anticoagulants for VTE prevention after joint arthroplasty and are associated with fewer bleeding complications.
Relative Risk: 1.08 (95% CI 0.81–1.44)
Purpose: Venous thromboembolism (VTE), encompassing deep vein thrombosis (DVT) and pulmonary embolism (PE), remains a major risk after joint arthroplasty. This study compares antiplatelet agents versus anticoagulants for VTE prevention in adults undergoing joint arthroplasty. Methods: The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Systematic searches were conducted in PubMed, EMBASE, Web of Science, and the Cochrane Central Register of Controlled Trials. Randomized controlled trials (RCTs) comparing antiplatelets with anticoagulants for VTE prevention in adults undergoing joint arthroplasty were included. Data were pooled using a random effects meta-analysis to account for heterogeneity. Results: Nineteen RCTs involving 30,290 patients met the inclusion criteria. No significant difference was found between antiplatelet agents and anticoagulants in preventing VTE (risk ratio (RR): 1.08; 95% CI: 0.81-1.44), DVT (RR: 1.12; 95% CI: 0.83-1.51), or PE (RR: 1.26; 95% CI: 0.94-1.69). However, in studies conducted after 2015 and those incorporating mechanical prophylaxis, the antiplatelet group had higher rates of VTE, DVT, and PE. Notably, female patients on antiplatelets had lower VTE rates, suggesting potential sex-specific benefits. Regarding safety, antiplatelet agents were associated with fewer bleeding complications compared to anticoagulants. Conclusion: Antiplatelet agents are as effective as anticoagulants in preventing VTE, DVT, and PE after joint arthroplasty and may offer a better safety profile with fewer bleeding complications. Despite some heterogeneity and potential biases, the evidence supports considering antiplatelet agents, particularly aspirin, as a cost-effective and reliable option for VTE prophylaxis in this patient population.
Zhang et al. (Wed,) conducted a meta-analysis in Venous thromboembolism prevention after joint arthroplasty (n=30,290). Antiplatelet agents vs. Anticoagulants was evaluated on Venous thromboembolism (VTE) (RR 1.08, 95% CI 0.81-1.44). Antiplatelet agents showed no significant difference compared to anticoagulants in preventing VTE after joint arthroplasty (RR 1.08; 95% CI 0.81-1.44).