Meta-analysis of 52 RCTs (10,929 patients) comparing five VTE prophylaxis agents — LMWH, warfarin, aspirin, low-dose heparin, and pneumatic compression — against each other and placebo after elective THA. All included trials required bilateral venography for DVT diagnosis. Asks: which agent best balances thromboembolic protection against bleeding risk?
When selecting VTE prophylaxis for elective THA, warfarin offers the best-evidenced balance of proximal DVT and symptomatic PE prevention with acceptable bleeding risk; low-dose unfractionated heparin should be avoided given its significantly elevated major bleeding risk without superior efficacy.
LMWH is a reasonable alternative to warfarin for DVT reduction but carries higher minor bleeding rates, and the two agents show overlapping confidence intervals for proximal DVT and PE — meaning neither is definitively superior on efficacy alone.
Meta-analysis of 52 RCTs (10,929 patients) comparing five VTE prophylaxis agents — LMWH, warfarin, aspirin, low-dose heparin, and pneumatic compression — against each other and placebo after elective THA. All included trials required bilateral venography for DVT diagnosis. Asks: which agent best balances thromboembolic protection against bleeding risk?
When selecting VTE prophylaxis for elective THA, warfarin offers the best-evidenced balance of proximal DVT and symptomatic PE prevention with acceptable bleeding risk; low-dose unfractionated heparin should be avoided given its significantly elevated major bleeding risk without superior efficacy.
LMWH is a reasonable alternative to warfarin for DVT reduction but carries higher minor bleeding rates, and the two agents show overlapping confidence intervals for proximal DVT and PE — meaning neither is definitively superior on efficacy alone.