Hematolgy
Contributions
Type: Publication Only
Background
The risk of recurrent venous thromboembolism persists for several years after the interruption of anticoagulant treatment. The role of aspirin in the primary prevention of venous thromboembolism has been evaluated by different groups. In these studies, treatment with low-dose aspirin (100 mg / day) was associated with a reduced risk from 20-50%. The benefit of antiplatelet therapy for secondary prevention of VTE was evidenced by the results of WARFASA study.
Aims
To evaluate the efficacy of aspirin for the prevention of recurrent venous thromboembolism after treatment with vitamin K antagonists in an unselected group of patients with VTE.
Methods
105 patients with VTE referred to the Hematology consultation during last year were included, the mean age of the group was 52.83 ± 18.40 (63.8% were women, n = 67). From each patient cardiovascular risk factors and the location of thrombosis were collected. Aspirin administration was decided depending on the presence of cardiovascular risk factors. Aspirin was prescribed in patients with 2 or more risk factors.
Results
The characteristics of the population and the result of the comparison of both groups are shown in Table 1. The mean follow-up period after discontinuation of OAT was 35.96 ± 19.49 months, after which 15 cases of recurrent thrombosis (14.3%) and 31 cases of post-thrombotic syndrome (29.5%) were diagnosed. Figure 1 shows the distribution of patients according to the location of the thrombosis. The mean duration of OAT was 12.63 ± 9.79. 87.6% of patients (n = 92) were treated with acenocoumarol and 12.4% were treated with LMWH (n = 13).
Finally, 49 patients were treated with low dose aspirin (46,7%). In this group 20.4% (n=10) patients had recurrent VTE, compared to the patients not prescribed with aspirine 8,9% (n=5) (p=ns). The number of PTS diagnosed was similar in both groups (26.8% (n = 15) vs 32.7% (n = 16); p = 0.6577).
| VTE | Aspirin | No aspirin | p |
Age | 52,83±18,40 | 55,45 ±16,06 | 50,54±20,10 | 0,1735 |
Dyslipemia | 32,7 (33) | 41,7 (20) | 24,5 (13) | 0,1049 |
Smoke | 24,8 (26) | 18,4 (9) | 30,4 (17) | 0,2327 |
Obesity | 15,2 (16) | 16,3 (8) | 14,3 (8) | 0,9855 |
Hypertension | 26,7 (28) | 30,6(15) | 23,2 (13) | 0,5261 |
DM | 3,8 (4) | 6,1 (3) | 1,8 (1) | 0,3370 |
CVD | 5,0 (5) | 6,1 (3) | 3,6 (2) | 0,0491 |
Summary
The results we obtained are consistent with those published in the WARFASA study, although we found no statistically significant difference in the recurrence rate. It would be interesting to extend this study including a larger population and review the selection criteria to choose patients who may benefit with aspirin treatment; and also a prospective analysis of the evolution of the patients treated with low-dose aspirin.
Keyword(s): Recurrence, Risk factor, Thromboembolic events, Thromboembolism
Session topic: Publication Only
Type: Publication Only
Background
The risk of recurrent venous thromboembolism persists for several years after the interruption of anticoagulant treatment. The role of aspirin in the primary prevention of venous thromboembolism has been evaluated by different groups. In these studies, treatment with low-dose aspirin (100 mg / day) was associated with a reduced risk from 20-50%. The benefit of antiplatelet therapy for secondary prevention of VTE was evidenced by the results of WARFASA study.
Aims
To evaluate the efficacy of aspirin for the prevention of recurrent venous thromboembolism after treatment with vitamin K antagonists in an unselected group of patients with VTE.
Methods
105 patients with VTE referred to the Hematology consultation during last year were included, the mean age of the group was 52.83 ± 18.40 (63.8% were women, n = 67). From each patient cardiovascular risk factors and the location of thrombosis were collected. Aspirin administration was decided depending on the presence of cardiovascular risk factors. Aspirin was prescribed in patients with 2 or more risk factors.
Results
The characteristics of the population and the result of the comparison of both groups are shown in Table 1. The mean follow-up period after discontinuation of OAT was 35.96 ± 19.49 months, after which 15 cases of recurrent thrombosis (14.3%) and 31 cases of post-thrombotic syndrome (29.5%) were diagnosed. Figure 1 shows the distribution of patients according to the location of the thrombosis. The mean duration of OAT was 12.63 ± 9.79. 87.6% of patients (n = 92) were treated with acenocoumarol and 12.4% were treated with LMWH (n = 13).
Finally, 49 patients were treated with low dose aspirin (46,7%). In this group 20.4% (n=10) patients had recurrent VTE, compared to the patients not prescribed with aspirine 8,9% (n=5) (p=ns). The number of PTS diagnosed was similar in both groups (26.8% (n = 15) vs 32.7% (n = 16); p = 0.6577).
| VTE | Aspirin | No aspirin | p |
Age | 52,83±18,40 | 55,45 ±16,06 | 50,54±20,10 | 0,1735 |
Dyslipemia | 32,7 (33) | 41,7 (20) | 24,5 (13) | 0,1049 |
Smoke | 24,8 (26) | 18,4 (9) | 30,4 (17) | 0,2327 |
Obesity | 15,2 (16) | 16,3 (8) | 14,3 (8) | 0,9855 |
Hypertension | 26,7 (28) | 30,6(15) | 23,2 (13) | 0,5261 |
DM | 3,8 (4) | 6,1 (3) | 1,8 (1) | 0,3370 |
CVD | 5,0 (5) | 6,1 (3) | 3,6 (2) | 0,0491 |
Summary
The results we obtained are consistent with those published in the WARFASA study, although we found no statistically significant difference in the recurrence rate. It would be interesting to extend this study including a larger population and review the selection criteria to choose patients who may benefit with aspirin treatment; and also a prospective analysis of the evolution of the patients treated with low-dose aspirin.
Keyword(s): Recurrence, Risk factor, Thromboembolic events, Thromboembolism
Session topic: Publication Only