SATURDAY, Dec. 10 (HealthDay News) -- Giving low-dose aspirin to
patients after they've received stronger blood thinners for
dangerous clots in the lungs could cut their odds of redeveloping
the clots, a new study finds.
The clots in question are venous thromboembolisms (VTEs). These
can include both the leg clots known as deep-vein thromboses, or
pulmonary embolisms, clots in the lungs that can cause rapid pulse,
shortness of breath, chest pain and even death.
Patients with VTE are typically given anticoagulants such as
warfarin (Coumadin) to help prevent future clots and dissolve
existing clots in the veins. However, about 15 to 20 percent of VTE
patients redevelop blood clots within two years after completing
such treatment, according to background information in the
study.
Extending blood thinner treatment with powerful medicines such
as warfarin can prevent recurrences, but it also carries an
increased risk of bleeding. So, the longer term use of aspirin as
an alternative therapy against recurrent blood clots in VTE
patients has been advocated but is controversial. That's because
aspirin is typically used to prevent clots in the arteries, not the
veins, and studies have yielded mixed findings about the aspirin's
effectiveness against VTEs.
This new study examined whether two years of low-dose (100
milligrams per day) aspirin therapy after an initial six to 12
months of warfarin therapy could prevent recurrent blood clots in
VTE patients. The patients were followed for up to three years
after completing their aspirin therapy.
The Italian researchers reported that blood clots recurred in 28
of the 205 patients who took aspirin and in 43 of the 197 patients
who took a placebo -- 6.6 percent versus 11.2 percent per
patient-year, respectively.
Major bleeding occurred in one patient in each group and there
was a similar rate of non-major bleeding.
The study was scheduled to be presented Saturday at the annual
meeting of the American Society of Hematology (ASH) in San
Diego.
"There has been significant debate on whether giving aspirin to a patient who suffers from VTE is beneficial," lead author Dr. Cecilia Becattini, an assistant professor of internal medicine in the Internal and Cardiovascular Medicine and Stroke Unit at the University of Perugia, said in an ASH meeting news release. "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."
Experts reacted positively to the new findings.
"This is a very important trial demonstrating a safe and effective alternative to long-term warfarin to reduce the incidence of recurrent venous thromboembolism," said Dr. Robert Lookstein, director of cardiovascular imaging at Mount Sinai Medical Center in New York City. "This trial shows that a simple medication such as once-a-day aspirin can safely reduce the risk of recurrent DVT and protect patients against these devastating consequences," he added.
But another expert noted an important caution. "It should be
emphasized that this does
not replace the initial treatment of VTE, which is heparin or
warfarin anticoagulation," said Dr. Glenn Jacobowitz, vice-chair of
the vascular surgery division at NYU Langone Medical Center in New
York City. "In my practice I would consider recommending low-dose
aspirin after warfarin anticoagulation courses are finished for
VTE. Patients should ask their physician about switching to
lifetime low-dose aspirin after finishing a standard six- to
12-month course of warfarin anticoagulation for VTE."
Data presented at medical meetings should be considered
preliminary until published in a peer-reviewed journal.
More information
The American Academy of Family Physicians has more about
deep vein thrombosis.