Rochester, MN: Twice-daily low-dose aspirin is equally effective as twice daily regular-dose aspirin for the prevention of venous thromboembolism (VTE) in patients with primary TJAs, finds a recent study in the Journal of Arthroplasty. The researchers found no difference in risk of mortality or gastrointestinal bleeds in the two groups.
Whether low-dose (81 mg) or regular-dose (325 mg) aspirin (ASA) is more effective for VTE chemoprophylaxis in primary total joint arthroplasties (TJAs) is not clear. To fill this knowledge gap, Mason E. Uvodich, Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, and colleagues aimed to evaluate the efficacy of low-dose and regular-dose ASA for VTE chemoprophylaxis in primary total hip arthroplasties and total knee arthroplasties.
For the purpose, the researchers retrospectively identified 3512 primary TJAs (2344 total hip arthroplasties and 1168 total knee arthroplasties). In these cases ASA was used as VTE chemoprophylaxis between 2000 and 2019
Patients received ASA twice daily for 4-6 weeks after surgery with 961 (27%) receiving low-dose ASA and 2551 (73%) receiving regular-dose ASA.
The primary endpoint was 90-day incidence of symptomatic VTEs. Secondary outcomes were gastrointestinal (GI) bleeding events and mortality.
Key findings of the study include:
There was no difference in 90-day incidence of symptomatic VTEs between low-dose and regular-dose ASA (0% vs 0.1%, respectively).
There were no GI bleeding events in either group.
There was no difference in 90-day mortality between low-dose and regular-dose ASA (0.3% vs 0.1%, respectively).
"In 3512 primary TJA patients treated with ASA, we found a cumulative incidence of VTE <1% at 90 days," wrote the authors
"Although this study is underpowered, it appears that twice daily low-dose ASA was equally effective to twice daily regular-dose ASA for VTE chemoprophylaxis, with no difference in risk of GI bleeds or mortality," they concluded.
The study titled, "Low-Dose vs Regular-Dose Aspirin for Venous Thromboembolism Prophylaxis in Primary Total Joint Arthroplasty," is published in the Journal of Arthroplasty.
DOI: https://www.arthroplastyjournal.org/article/S0883-5403(21)00133-9/fulltext