Key result
Acetylsalicylic acid alone yielded 14.5 arterial embolic complications per 100 patient-years in patients with aortic ball valves, appearing inferior to anticoagulants in those with arrhythmia.
Why the study?
Does acetylsalicylic acid alone prevent arterial thromboembolism in patients with aortic ball valve prostheses?
Observational (n=77)
Does acetylsalicylic acid alone prevent arterial thromboembolism in patients with aortic ball valve prostheses?
Acetylsalicylic acid alone is inferior to anticoagulation for preventing thromboembolism in patients with aortic ball valve prostheses and arrhythmia, and combined therapy remains preferred.
Answers are grounded in this paper and cite their sources.
Acetylsalicylic acid alone may inadequately prevent thromboembolism in aortic ball valve patients with arrhythmia; leaves open the need for randomized confirmation versus anticoagulation.
Encouraged by the effective prevention of arterial thromboembolism with a combination of ASA and anticoagulants (9), the present study was done in 77 patients with a single Starr-Edwards aortic ball valve. They received one gm. of ASA daily, then the dose of anticoagulants was reduced gradually and the drug discontinued on average five weeks later. Six arterial embolic episodes occurred in five patients, the incidence being 14.5 complications per 100 patients per year. Five emboli were cerebral, none of them serious, and one was removed from a femoral artery. Four of the embolic episodes occurred in three of the 11 patients with continuous arrhythmia, probably from venus thrombi that developed in the left atrium. The occurrence of only two embolic complications in the 66 patients with sinus rhythm suggests some prevention of arterial thrombus formation on the prosthetic valves. The results indicate that ASA is inferior to anticoagulants in patients with arrhythmia, while it may represent an alternative to anticoagulation in individuals with sinus rhythm. We prefer, however, the combined therapy in patients with aortic valve prostheses because of the strong anti-thrombotic effect achieved by this treatment.
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Dale et al. (1981) conducted an observational in Aortic ball valve prostheses (n=77). Acetylsalicylic acid (ASA) vs. Anticoagulants was evaluated on Arterial embolic episodes. Acetylsalicylic acid alone yielded 14.5 arterial embolic complications per 100 patient-years in patients with aortic ball valves, appearing inferior to anticoagulants in those with arrhythmia.
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