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June 10, 1971New England Journal of Medicine

Reduction in Venous Thromboembolism by Agents Affecting Platelet Function

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Why the study?

Do agents affecting platelet function (dipyridamole, aspirin, dextran) prevent venous thrombosis and pulmonary embolism compared to warfarin in patients undergoing vitallium-mold arthroplasty of the hip?

Population

169 patients undergoing vitallium-mold arthroplasty of the hip

Comparison

Prophylactic administration of dipyridamole… vs Warfarin

Design

Cohort

Authors

ESEdwin W. SalzmanCross-Cutting CardiologyWHWilliam H. HarrisButler UniversityRDRoman W. DeSanctisElectrophysiology

Discussion

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Overview

Aspirin or dextran may match warfarin's thromboembolic protection after hip arthroplasty; this Level 3 evidence leaves open the need for randomized confirmation.

Key Points

  • To assess the efficacy of three platelet-active agents (dipyridamole, aspirin, and dextran) compared with warfarin in preventing venous thromboembolism after hip arthroplasty.
  • Controlled comparative study of N=169 patients undergoing vitallium-mold arthroplasty of the hip.
  • Patients received prophylactic regimens of warfarin (n=43), dipyridamole (n=34), aspirin (n=43), or dextran (n=49), with outcomes evaluated against a historical untreated cohort (n=67).
  • Thromboembolic complications occurred in 6 of 43 patients (14.0%) receiving warfarin, 6 of 43 (14.0%) receiving aspirin, 6 of 49 (12.2%) receiving dextran, and 9 of 34 (26.5%) receiving dipyridamole, compared to 26 of 67 (38.8%) in historical untreated controls.
  • Bleeding complications occurred at frequencies that did not differ significantly among the four treatment arms.

Structured PICO

Do agents affecting platelet function (dipyridamole, aspirin, dextran) prevent venous thrombosis and pulmonary embolism compared to warfarin in patients undergoing vitallium-mold arthroplasty of the hip?

P
Population
169 patients undergoing vitallium-mold arthroplasty of the hip
I
Intervention
Prophylactic administration of dipyridamole, aspirin, or dextran
C
Comparator
Warfarin
O
Outcome
Venous thrombosis and pulmonary embolism (thromboembolic complications)hard clinical

Aspirin and dextran appear to offer similar protection against thromboembolic complications as warfarin in patients undergoing hip arthroplasty, whereas dipyridamole is less effective.

Cite This Study

Salzman et al. (1971) studied this question.

synapsesocial.com/papers/6a7be089ef97a97562c62704https://doi.org/10.1056/nejm197106102842303

Topics

Pulmonary embolism
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Anticoagulation for Prevention of Thromboembolism Following Fractures of the Hip1966 · 100 citations
  2. 2The effect of salicylates on the hemostatic properties of platelets in man1968 · 539 citations
  3. 3Dextran 75 and Postoperative Phlebitis1969 · 15 citations
  4. 4Dextran 70 in Prophylaxis of Postoperative Venous Thrombosis. A Controlled Trial1970 · 65 citations