April 2014, 22:9
03 December 2014
Aspirin for prophylaxis of venous thromboembolism
Cessation of vitamin K antagonists (VKA) after a primary incidence of spontaneous venous thromboembolism (VTE) has been associated with recurrent events in about one-fifth of patients. Although long-term continuation of VKA prophylaxis has been suggested as a means to prevent recurrent VTE, concerns remain over issues of high bleeding risk, patient non-compliance as well as dosage irregularities. Antiplatelet therapy has been proposed as a safer, cheaper and more convenient alternative for long-term prophylaxis after initial treatment with VKA following VTE. Here we compare two major randomized trials that were conducted back-to-back – the WARFASA trial and the ASPIRE trial – to determine the role of aspirin as a long-term treatment option to reduce the incidence of recurrent VTE. Despite the encouraging results of these trials, suggesting that aspirin may have a beneficial effect on secondary prevention of VTE, it must be emphasized that both trials only started aspirin after 6-18 months of treatment with VKA, which remain a cornerstone of management for a first unprovoked VTE.
Aspirin - Antiplatelet Therapy - High Bleeding Risk - Aspire Study - Aspire Trial
1 Yong Loo-Lin School of Medicine, National University of Singapore
2 National University Heart Centre, Singapore
Correspondence to Mark Y. Chan, Associate Professor
Yong Loo-Lin School of Medicine, National University of Singapore
1E, Kent Ridge Road, NUHS Tower Block, Level 9, Cardiac Department, Singapore 119228
Tel: +65 67725596 Fax: +65 68722998
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