Low-Dose Aspirin Is Safe and Effective for Venous Thromboembolism Prophylaxis Following Total Knee Arthroplasty.

Autor: Faour M; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio., Piuzzi NS; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio; Departamento de cirugía ortopédica, Instituto Universitario del Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Brigati DP; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio., Klika AK; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio., Mont MA; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio., Barsoum WK; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio., Higuera CA; Department of Orthopaedic Surgery, Cleveland Clinic Foundation, Cleveland, Ohio.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2018 Jul; Vol. 33 (7S), pp. S131-S135. Date of Electronic Publication: 2018 Mar 08.
DOI: 10.1016/j.arth.2018.03.001
Abstrakt: Background: Aspirin is an effective prophylaxis for venous thromboembolism (VTE) after total knee arthroplasty (TKA). The optimal prophylactic aspirin dose has not been established. The study aims to compare 2 aspirin regimens with regard to the incidence of (1) symptomatic deep venous thrombosis (DVT), (2) pulmonary embolism (PE), (3) bleeding, and (4) mortality within 90 days after TKA.
Methods: We retrospectively identified 5666 patients who received aspirin twice daily for 4 to 6 weeks after TKA. A total of 1327 patients received 81-mg BID and 4339 patients received 325-mg BID aspirin. Postoperative complications collected were VTEs (DVT and PE), bleeding (gastrointestinal or wound bleeding), and mortality.
Results: The incidence of VTE was 1.5% in the 325-mg group and 0.7% in the 81-mg group (P = .02). Symptomatic DVT was 1.4% in the 325-mg aspirin compared with 0.3% for the 81-mg aspirin (P = .0009). Regression model showed no correlation between aspirin dose and VTE incidence (odds ratio [OR] = 1.03; 95% confidence interval [95% CI], 0.45-2.36; P = .94) or DVT (OR = 0.50; 95% CI, 0.16-1.55; P = .20). The incidence of PE was 0.2% in the high-aspirin group compared with 0.4% in the low-aspirin group (P = .13). Bleeding was 0.2% in the 325-mg aspirin group and 0.2% in the 81-mg aspirin group (P = .62), and 90-day mortality was similar (0.1%) between the groups (P = .56).
Conclusion: Low-dose aspirin was not inferior to high-dose aspirin for the prevention of VTE after TKA. Low-dose aspirin can be considered a safe and effective agent in the prevention of VTE after TKA.
(Copyright © 2018 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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