Low-Dose Aspirin Doesn't Prevent VTE Recurrence But Does Reduce Vascular Events

Aspirin maintenance therapy after venous thromboembolism — although not better than placebo at preventing recurrence — does reduce risks for major vascular events, according to a study presented at the American Heart Association meeting and published in the New England Journal of Medicine.

Researchers randomized some 800 patients with first episodes of unprovoked VTE to 100 mg of aspirin or placebo daily. All had completed therapy with anticoagulants.

During a median follow-up of roughly 3 years, VTE recurrence (the primary outcome) did not differ significantly between the groups. However, composite outcomes that included VTE, MI, stroke, major bleeding, and death (secondary endpoints) were reduced by about one third with aspirin.

Allan S. Brett writes in Journal Watch General Medicine: "After completing initial courses of anticoagulation, patients with unprovoked VTE are at high risk for recurrence. Indefinite continuation of warfarin lowers that risk substantially but confers considerable ongoing bleeding risk. Aspirin offers a reasonable compromise for such patients."