Rivaroxaban: a new orally active direct inhibitor of Factor Xa

Deep vein thrombosis (DVT) is a common complication in hospital patients who do not receive thromboprophylaxis. Due to the shortcomings of the available evidence the true incidence is unclear, but data from the placebo arms of randomised trials of thromboprophylaxis, believed to be the best source,¹ show that the incidence varies by specialty (Table 1). The risk in medical inpatients is often underestimated: the incidence of DVT is particularly high among patients admitted with stroke, heart failure or myocardial infarction.² However, patients undergoing orthopaedic surgery are at greatest risk, with DVT occurring in approximately one-quarter to one-half. There is also evidence to suggest that individual risk is influenced by a large number of risk factors (Table 2).¹ Copyright © 2008 John Wiley & Sons, Ltd.