Abstract
Introduction: Oral anticoagulants can be used for prevention and treatment of thrombosis. New oral anticoagulants such as rivaroxaban provide more consistent and predictable anticoagulation than warfarin as they are direct factor Xa inhibitor. The aim of this review is to evaluate the evidence of using prophylactic medications to prevent thromboembolism in hospitalized patients.
Methods: An electronic search in MEDLINE was conducted with no limits applied regarding age of the patients or the type of injury because some of studied medications are relatively recent and any available study would add significantly to the review. Included studies were aimed to evaluate the use of prophylactic medications to prevent thromboembolism in hospitalized patients who have been indicated to major surgical interventions. Any study met these inclusion criteria were eligible in this review.
Results: The MEDLINE search resulted in 97 studies which underwent screening of the eligibility criteria and 11 studies met the inclusion criteria. The thromboprophylaxis effect was higher when rivaroxaban compared to no treatment or placebo, while no significant differences were found when rivaroxaban, dalteparin or lowmolecular-weight heparin compared to placebo. Moreover, when medications compared to each other, no significant difference in thromboprophylaxis effect was reported in many included studies. Only edoxaban and dabigatran were found superior to enoxaparin by two included studies.
Conclusion: This review showed that new oral anticoagulants could be effective in reducing risk of thrombosis particularly in high-risk patients subjected to major surgery.