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Despite evidence-based recommendations in current guidelines, many patients who undergo hip surgery do not receive anticoagulant therapy to prevent venous thromboembolism after hospital discharge. Rivaroxaban is a promising, new, oral, direct factor Xa inhibitor with high bioavailability, rapid onset of action, a half-life of 5 to 9 hours, and a predictable anticoagulant response that obviates the need for monitoring that encumbers the protracted use of warfarin. In four large phase III trials involving more than 12,500 patients, rivaroxaban has been shown to be superior to low-dose enoxaparin for venous thromboembolism prophylaxis after hip or knee surgery (JW Oncol Hematol Jun 25 2008).
In the RECORD2 trial, 2509 patients undergoing total …