Key result
Aspirin prophylaxis after hip or knee arthroplasty was associated with a non-significant reduction in VTE compared to other anticoagulants (RR 0.87) and a significant reduction compared to placebo (RR 0.65).
Why the study?
Patients undergoing knee or hip arthroplasty face significant VTE risk, and various thromboprophylactic strategies yield different outcomes, prompting evaluation of the efficacy and safety of aspirin versus placebo or anticoagulants.
Does aspirin prophylaxis reduce VTE incidence in patients who underwent knee or hip arthroplasty?
Population
20,115 patients across 13 RCTs after knee or hip arthroplasty
Comparison
Aspirin prophylaxis vs placebo or anticoagulants
Design
Meta-analysis of randomized controlled trials
Authors
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Aspirin matches anticoagulants for VTE prevention and safety after hip/knee arthroplasty while outperforming placebo; strengthens case for its first-line use in RCTs.
Meta-Analysis (n=20,115)
Does aspirin prophylaxis reduce VTE incidence in patients who underwent knee or hip arthroplasty?
Relative Risk: 0.87 (95% CI 0.61–1.23)
p-value: p=0.43
Aspirin provides similar efficacy and safety to anticoagulants for VTE prophylaxis after hip or knee arthroplasty, and significantly reduces VTE compared to placebo.
Haykal et al. (2019) conducted a meta-analysis in Venous thromboembolism prophylaxis after hip or knee arthroplasty (n=20,115). Aspirin vs. Placebo or other anticoagulants (LMWH, NOACs, warfarin, heparin) was evaluated on Venous thromboembolism (VTE) incidence (RR 0.87, 95% CI 0.61-1.23, p=0.43). Aspirin prophylaxis after hip or knee arthroplasty was associated with a non-significant reduction in VTE compared to other anticoagulants (RR 0.87) and a significant reduction compared to placebo (RR 0.65).
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