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Article Navigation >  Medical Journal of Peking Union Medical College Hospital  > 2019  >  10(6): 639-646
Shi-liang CAO, Yi REN, Bin FENG. Aspirin:A New Choice for Prevention of Venous Thromboembolism after Arthroplasty[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(6): 639-646. doi: 10.3969/j.issn.1674-9081.2019.06.016
Citation: Shi-liang CAO, Yi REN, Bin FENG. Aspirin:A New Choice for Prevention of Venous Thromboembolism after Arthroplasty[J]. Medical Journal of Peking Union Medical College Hospital, 2019, 10(6): 639-646. doi: 10.3969/j.issn.1674-9081.2019.06.016
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Aspirin:A New Choice for Prevention of Venous Thromboembolism after Arthroplasty

doi: 10.3969/j.issn.1674-9081.2019.06.016

  • Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China

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  • Corresponding author: FENG Bin Tel: 86-10-69152800, E-mail:fengbin@pumch.cn
  • Received Date: 2018-01-02
  • Publish Date: 2019-11-30
    Abstract
  • Venous thromboembolism is a serious complication after orthopedics arthroplasty, which could result in significant loss of patients' satisfaction with the artificial joint. In some extreme cases, it also could lead to the death from respiratory and circulatory failure. The most important and effective method to prevent this complication is preoperative anti-coagulation therapy that could greatly reduce the incidence of venous thromboembolism after arthroplasty. Anticoagulant drugs, such as low molecular weight heparin, Xa factor inhibitors, are the first choices for anti-coagulation therapy after arthroplasty. These drugs have certain effectiveness and low risk of postoperative bleeding, but there are still some deficiencies, including expensiveness, parenteral administration, and so on. Aspirin is a historical antiplatelet drug. Now some guides and researches suggest it also can be a choice for the prevention of venous thromboembolism after arthroplasty. In these researches, aspirin was found to have similar prophylactic effect and safety compared to anticoagulant drugs in the prevention of venous thromboembolism after arthroplasty. Aspirin is cheaper and economical. It can be administered orally, which is convenient for patients. Some researchers also believe aspirin has a lower bleeding rate compared with anticoagulant drugs. In terms of drug dose, low-dose aspirin has a sufficient preventive effect for venous throm-boembolism, which could reduce the side effect of gastrointestinal adverse reactions. In conclusion, aspirin is a new choice for the prevention of venous thromboembolism after arthroplasty.
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  • [1] 中华医学会骨科学分会.中国骨科大手术静脉血栓栓塞症预防指南[J].中华骨科杂志, 2016, 36:65-69. http://qikan.cqvip.com/Qikan/Article/Detail?id=30676461
    [2] 刘凤林, 秦净.从指南到实践:解析《中国普通外科围手术期血栓预防与管理指南》[J].协和医学杂志, 2018, 9:144-149. http://www.cnki.com.cn/Article/CJFDTotal-XHYX201802008.htm
    [3] Undas A, Brummel-Ziedins K, Mann KG. Why does aspirin decrease the risk of venous thromboembolism? On old and novel antithrombotic effects of acetyl salicylic acid[J]. J Thromb Haemost, 2014, 12:1776-1787. doi:  10.1111/jth.12728
    [4] British Medical Journal Publishing Group. Collaborative overview of randomised trials of antiplatelet therapy-Ⅲ:reduction in venous thrombosis and pulmonary embolism by antiplatelet prophylaxis among surgical and medical patients[J]. BMJ, 1994, 308:235-246. doi:  10.1136/bmj.308.6923.235
    [5] Bloch BV, Patel V, Best AJ. Thromboprophylaxis with dabigatran leads to an increased incidence of wound leakage and an increased length of stay after total joint replacement.[J]. Bone Joint J, 2014, 96-B:122-126. http://europepmc.org/abstract/med/24395322
    [6] Semeraro F, Ammollo CT, Morrissey JH, et al. Extracellular histones promote thrombin generation through platelet-dependent mechanisms:involvement of platelet TLR2 and TLR4[J]. Blood, 2011, 118:1952-1961. http://www.ncbi.nlm.nih.gov/pubmed/21673343
    [7] Szczeklik A, Krzanowski M, Gora P, et al. Antiplatelet drugs and generation of thrombin in clotting blood[J]. Blood, 1992, 80:2006-2011. doi:  10.1182/blood.V80.8.2006.2006
    [8] Osnes LT, Foss KB, Joo GB, et al. Acetylsalicylic acid and sodium salicylate inhibit LPS-induced NF-kappa B/c-Rel nuclear translocation, and synthesis of tissue factor (TF) and tumor necrosis factor alfa (TNF-alpha) in human monocytes[J]. Thromb Haemost, 1996, 76:970-976. doi:  10.1055/s-0038-1650694
    [9] Undas A, Undas R, Musial J, et al. A low dose of aspirin (75 mg/day) lowers thrombin generation to a similar extent as a high dose of aspirin (300 mg/day)[J]. Blood Coagul Fibrinolysis, 2000, 11:231-234.
    [10] He S, Bark N, Wang H, et al. Effects of acetylsalicylic acid on increase of fibrin network porosity and the consequent upregulation of fibrinolysis[J]. J Cardiovasc Pharmacol, 2009, 53:24-29. doi:  10.1097/FJC.0b013e3181953e0f
    [11] Ajjan RA, Standeven KF, Khanbhai M, et al. Effects of aspirin on clot structure and fibrinolysis using a novel in vitro cellular system[J]. Arterioscler Thromb Vasc Biol, 2009, 29:712-717. doi:  10.1161/ATVBAHA.109.183707
    [12] Antovic A, Perneby C, Ekman GJ, et al. Marked increase of fibrin gel permeability with very low dose ASA treatment[J]. Thromb Res, 2005, 116:509-517. doi:  10.1016/j.thromres.2005.02.007
    [13] Nielen JTH, Dagnelie PC, Emans PJ, et al. Safety and efficacy of new oral anticoagulants and low-molecular-weight heparins compared with aspirin in patients undergoing total knee and hip replacements[J]. Pharmacoepidemiology Drug Saf, 2016, 25:1245-1252. doi:  10.1002/pds.4089
    [14] Salzman EW, Harris WH, DeSanctis RW. Reduction in venous thromboembolism by agents affecting platelet function[J]. N Engl J Med, 1971, 284:1287-1292. doi:  10.1056/NEJM197106102842303
    [15] Guyatt GH, Akl EA, Crowther M, et al. Executive Summary:Antithrombotic Therapy and Prevention of Thrombosis, 9 ed:American College of Chest Physicians Evidence-Based Clinical Practice Guidelines[J]. Chest, 2012, 141:7S-47S. doi:  10.1378/chest.1412S3
    [16] Johanson NA, Lachiewicz PF, Lieberman JR, et al. Prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty[J]. J Am Acad Orthop Surg, 2009, 17:183-196. doi:  10.5435/00124635-200903000-00007
    [17] Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin: Pulmonary Embolism Prevention (PEP) trial[J]. Lancet, 2000, 355: 1295-1302.
    [18] Anderson DR, Dunbar MJ, Bohm ER, et al. Aspirin versus low-molecular-weight heparin for extended venous thromboembolism prophylaxis after total hip arthroplasty:a randomized trial[J]. Ann Intern Med, 2013, 158:800-806. doi:  10.7326/0003-4819-158-11-201306040-00004
    [19] Anderson DR, Dunbar M, Murnaghan J, et al. Aspirin or Rivaroxaban for VTE Prophylaxis after Hip or Knee Arthroplasty[J]. N Engl J Med, 2018, 378:699-707. doi:  10.1056/NEJMoa1712746
    [20] Chu J, Maselli J, Auerbach AD, et al. The risk of venous thromboembolism with aspirin compared to anticoagulants after hip and knee arthroplasty[J]. Thromb Res, 2017, 155:65-71. doi:  10.1016/j.thromres.2017.04.012
    [21] Raphael IJ, Tischler EH, Huang R, et al. Aspirin:an alternative for pulmonary embolism prophylaxis after arthroplasty?[J]. Clin Orthop Relat Res, 2014, 472:482-488. doi:  10.1007/s11999-013-3135-z
    [22] Wang Z, Zheng J, Zhao Y, et al. Effectiveness and Tolerability of Anticoagulants for Thromboprophylaxis after Major Joint Surgery:a Network Meta-Analysis[J]. Cell Physiol Biochem, 2017, 42:1999-2020. doi:  10.1159/000479840
    [23] Zou Y, Tian S, Wang Y, et al. Administering aspirin, rivaroxaban and low-molecular-weight heparin to prevent deep venous thrombosis after total knee arthroplasty[J]. Blood Coagul Fibrinolysis, 2014, 25:660-664. doi:  10.1097/MBC.0000000000000121
    [24] Jiang Y, Du H, Liu J, et al. Aspirin combined with mechanical measures to prevent venous thromboembolism after total knee arthroplasty:a randomized controlled trial[J].Chin Med J (Engl), 2014, 127:2201-2205. http://2010.cqvip.com/QK/85656X/201412/661620339.html
    [25] Agaba P, Kildow BJ, Dhotar H, et al. Comparison of postoperative complications after total hip arthroplasty among patients receiving aspirin, enoxaparin, warfarin, and factor Xa inhibitors[J]. J Orthop, 2017, 14:537-543. doi:  10.1016/j.jor.2017.08.002
    [26] Cafri G, Paxton EW, Chen Y, et al. Comparative Effectiveness and Safety of Drug Prophylaxis for Prevention of Venous Thromboembolism After Total Knee Arthroplasty[J]. J Arthroplasty, 2017, 32:3524-3528. doi:  10.1016/j.arth.2017.05.042
    [27] Burger W, Kneissl GD. Low-dose aspirin for secondary cardiovascular prevention-cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation-review[J]. J Intern Med, 2005, 257:399-414. doi:  10.1111/j.1365-2796.2005.01477.x
    [28] Patel PA, Fleisher LA. Aspirin, clopidogrel, and the surgeon[J]. Adv Surg, 2014, 48:211-222. doi:  10.1016/j.yasu.2014.05.005
    [29] Meier R, Marthy R, Saely CH, et al. Comparison of preoperative continuation and discontinuation of aspirin in patients undergoing total hip or knee arthroplasty[J]. Eur J Orthop Surg Traumatol, 2016, 26:921-928. doi:  10.1007/s00590-016-1830-7
    [30] Schwab PE, Lavand'homme P, Yombi J, et al. Aspirin mono-therapy continuation does not result in more bleeding after knee arthroplasty[J]. Knee Surg Sports Traumatol Arthrosc, 2017, 25:2586-2593. doi:  10.1007/s00167-015-3824-0
    [31] Radzak KN, Wages JJ, Hall KE, et al. Rate of Transfusions After Total Knee Arthroplasty in Patients Receiving Lovenox or High-Dose Aspirin[J]. J Arthroplasty, 2016, 31:2447-2451. doi:  10.1016/j.arth.2015.10.023
    [32] Kulshrestha V, Kumar S. DVT prophylaxis after TKA:routine anticoagulation vs risk screening approach-a randomized study[J]. J Arthroplasty, 2013, 28:1868-1873. doi:  10.1016/j.arth.2013.05.025
    [33] Pesce V, Patella V, Scaraggi A, et al. Thrombocytopenia after total knee arthroplasty[J]. Orthopedics, 2008, 31:1239-1239.
    [34] Skelley JW, Kyle JA, Roberts RA. Novel oral anticoagulants for heparin-induced thrombocytopenia[J]. J Thromb Thrombolysis, 2016, 42:172-178. doi:  10.1007/s11239-016-1365-0
    [35] Roderick PJ, Wilkes HC, Meade TW. The gastrointestinal toxicity of aspirin:an overview of randomised controlled trials[J]. Br J Clin Pharmacol. 1993, 35:219-226. doi:  10.1111/j.1365-2125.1993.tb05689.x
    [36] Feldstein MJ, Low SL, Chen AF, et al. A Comparison of Two Dosing Regimens of ASA Following Total Hip and Knee Arthroplasties[J]. J Arthroplasty, 2017, 32:157-161. doi:  10.1016/j.arth.2017.01.009
    [37] Schousboe JT, Brown GA. Cost-effectiveness of low-molecular-weight heparin compared with aspirin for prophy-laxis against venous thromboembolism after total joint arthroplasty[J]. J Bone Joint Surg Am, 2013, 95:1256-1264. doi:  10.2106/JBJS.L.00400
    [38] Mostafavi TR, Rasouli MR, Maltenfort MG, et al. Cost-effective prophylaxis against venous thromboembolism after total joint arthroplasty:warfarin versus aspirin[J]. J Arthroplasty, 2015, 30:159-164. doi:  10.1016/j.arth.2014.08.018
    [39] Asopa V, Cobain W, Martin D, et al. Staged venous thromboemolic events prophylaxis with low-molecular-weight heparin followed by aspirin is safe and effective after arthroplasty[J]. ANZ J Surg, 2015, 85:652-657. doi:  10.1111/ans.13174
    [40] Wallen NH, Ladjevardi M. Influence of low-and high-dose aspirin treatment on thrombin generation in whole blood[J]. Thromb Res, 1998, 92:189-194. doi:  10.1016/S0049-3848(98)00126-1
    [41] Villanueva GB, Allen N. Acetylation of antithrombin Ⅲ by aspirin[J]. Semin Thromb Hemost, 1986, 12:213-215. doi:  10.1055/s-2007-1003553
    [42] Hart RG, Harrison MJ. Aspirin wars:the optimal dose of aspirin prevent stroke[J]. Stroke, 1996, 27:585-587. doi:  10.1161/01.STR.27.4.585
    [43] Parvizi J, Huang R, Restrepo C, et al. Low-Dose Aspirin Is Effective Chemoprophylaxis Against Clinically Important Venous Thromboembolism Following Total Joint Arthroplasty:A Preliminary Analysis[J]. J Bone Joint Surg Am, 2017, 99:91-98. doi:  10.2106/JBJS.16.00147
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