Issue: June 2018
Perspective from Jay R. Lieberman, MD
June 14, 2018
3 min read
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Low-dose aspirin may prevent PE, DVT events in patients after TKA

Research into the effect of even lower aspirin doses on venous thromboembolism would be helpful.

Issue: June 2018
Perspective from Jay R. Lieberman, MD
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Low-dose aspirin used for the prevention of venous thromboembolism following total knee arthroplasty showed similar effects to those seen with high-dose aspirin, according to results published in The Journal of Arthroplasty.

Compared to high-dose aspirin in the setting of TKA, “We found out low-dose aspirin showed similar prophylactic effect in terms of venous thromboembolism — both pulmonary embolism [PE] and deep venous thrombosis — and they appeared to have similar complication profiles in terms of bleeding, whether it was wound bleeding or gastrointestinal bleeding, as well as mortality within 90 days after surgery,” Mhamad Faour, MD, clinical research fellow at Cleveland Clinic Foundation, told Orthopedics Today.

Mhamad Faour, MD
Mhamad Faour

Faour and his colleagues collected postoperative information about complications, including VTE, bleeding and mortality, for 5,666 patients who received either 81-mg (n=1,327, low-dose group) or 325-mg (n=4,339, high-dose group) aspirin twice daily for 4 to 6 weeks after TKA.

The researchers found the VTE incidence was 0.5% for patients who received 325-mg aspirin and 0.7% for patients who received 81-mg aspirin. They noted the incidence of symptomatic DVT was 1.4% and 0.3% in the high-dose and low-dose groups, respectively.

Aspirin dose had no correlation with VTE or DVT incidence, according to a regression model. The high-dose aspirin group had a PE incidence of 0.2% vs. 0.4% in the low-dose aspirin group. In the findings, both groups showed similar complications of bleeding (0.2%) and mortality (0.1%).

According to Faour, low-dose aspirin can be considered a safe and effective agent in the prevention of VTE after TKA in low-risk patients. Although aspirin has been proven to prevent VTE, it is still associated with a risk of bleeding. Researchers should review whether an even lower dose of aspirin than was studied, such as 81 mg once daily, which is the dose recommended to prevent cardiovascular events, may be as effective for the prevention of VTE with lower risk of side effects. – by Casey Tingle

Disclosure: Faour reports no relevant financial disclosures.