New oral anticoagulants in venous thromboembolism prophylaxis in orthopaedic patients: Are they really better?

Michael H. Huo

doi:10.1160/TH10-10-0653

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2011; 106(01): 45-57
DOI: 10.1160/TH10-10-0653

Review Article

Schattauer GmbH

New oral anticoagulants in venous thromboembolism prophylaxis in orthopaedic patients: Are they really better?

Authors

Michael H. Huo

¹Department of Orthopedic Surgery, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA

Abstract

Summary

Prophylaxis against venous thromboembolism (VTE) is considered standard of care. Appropriate chemoprophylaxis for VTE has been mandated by the United States government agencies and consumer groups. However, controversies exist regarding the most clinically relevant and safe chemoprophylaxis protocols in patients undergoing joint replacement surgery. Thus, this paper reviews the clinical efficacy and safety of newer oral anticoagulants. A literature search was performed for oral anticoagulants in advanced stages of development using PubMed and abstracts from thrombosis meetings. Most clinical trial data have demonstrated equal or superior efficacy in venographic endpoints in comparison to low-molecular-weight heparins (LMWH). However, bleeding complications have been reported to occur with oral anticoagulants as frequently as or more frequently than with LMWH. Other potential complications reported include liver enzyme elevation and cardiac irregularities. It remains to be established whether newer oral anticoagulants will be better alternatives to the current standard-ofcare in real-life medical clinical practice.

Keywords

Oral anticoagulants - prophylaxis - safety - venous thromboembolism

Full Text

References

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