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Low-Dose Aspirin Could Prevent Recurrence of Lung Clots

Patients suffering from venous thromboembolism who are given an aspirin can help prevent the recurrence of potentially fatal blood clots.

Venous thromboembolism (VTE) is a clotting disorder that includes both deep-vein thrombosis and pulmonary embolism, which can lead to chest pain, shortness of breath, rapid pulse, and even sudden death. Patients who suffer from VTE are given oral anticoagulants, like warfarin, to dissolve existing clots or detached clots and help prevent clot growth in the veins.

Aspirin, which is an antiplatelet agent, blocks blood clots from forming in the arteries by preventing platelets from binding together and obstructing the blood flow to the heart or brain. This obstruction can cause a heart attack or stroke.

Approximately 15 to 20 percent of VTE patients experience a recurrence of these deadly clots two years after they finish conventional warfarin treatment. Although extending anticoagulant treatment helps prevent recurrence, it is also linked to an increased bleeding risk.

Using aspirin as an alternative therapy to oral anticoagulants is controversial because the drug is used to prevent blood clots in the arteries and not veins. Also previous studies assessing aspirin’s ability to reduce recurrence rates for VTE have been contradictory.

To assess aspirin’s safety and efficacy for the prevention of VTE recurrence after conventional therapy, Italian researchers conducted a randomized, placebo-controlled, double-blind WARFASA study.

Researchers wanted to discover if low-dose aspirin prevented recurrent VTE when administered for two years after an initial six to 12 months of warfarin therapy.

Study participants with a first unprovoked VTE (clot that occurs in the absence of known risk factors, such as surgery, prolonged immobilization, or trauma),

Study participants who finished six to 12 months of oral anticoagulant treatment were randomized with 205 receiving a daily dose of aspirin and 197 receiving a placebo for at least two years, with follow-up for up to three years. These participants had experienced their first unprovoked VTE, meaning the clot had occurred in the absence of known risk factors like surgery, prolonged immobilization, or trauma.

VTE recurrence was noted in 28 of the 205 patients who received aspirin or 6.6 percent and 43 of the 197 patients who received placebo or 11.2 percent. During the study treatment, 23 patients who received aspirin and 39 patients who received placebo experienced VTE recurrence (5.9 percent vs. 11 percent per patient-year, respectively). One patient in each study group suffered from major bleeding, with a similar incidence of clinically relevant non-major bleeding.

The primary efficacy outcome was recurrent symptomatic VTE and VTE-related death. Clinically relevant bleeding were the main safety outcomes.

“Our study shows that aspirin, a common and low-cost drug found in most medicine cabinets, can be a valid alternative to oral anticoagulants for the extended treatment of VTE,” said Dr. Cecilia Becattini, lead study author and professor of Internal Medicine at the University of Perugia in Italy.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.

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