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

Apr 17, 2018The Journal of arthroplasty

Low-Dose Aspirin Is a Safe and Effective Preventive Treatment for Blood Clots After Total Knee Replacement

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Abstract

The incidence of venous thromboembolism (VTE) was 1.5% in the 325-mg aspirin group and 0.7% in the 81-mg group.

Symptomatic deep venous thrombosis (DVT) occurred in 1.4% of the 325-mg group compared to 0.3% in the 81-mg group.
No correlation was found between aspirin dose and VTE incidence or DVT in regression analyses.
The incidence of pulmonary embolism (PE) was 0.2% in the high-dose group and 0.4% in the low-dose group.
Bleeding rates were identical at 0.2% for both the 325-mg and 81-mg aspirin groups.
90-day mortality rates were similar at 0.1% between both aspirin dosage groups.

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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.

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

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