Article

ASEAN Heart Journal

, 22:9

First online:

Open Access This content is freely available online to anyone, anywhere at any time.

Aspirin for prophylaxis of venous thromboembolism

  • Chloe TingAffiliated withYong Loo-Lin School of Medicine, National University of Singapore
  • , Leonardo P. de CarvalhoAffiliated withYong Loo-Lin School of Medicine, National University of SingaporeNational University Heart Centre
  • , Mark Y. ChanAffiliated withYong Loo-Lin School of Medicine, National University of SingaporeNational University Heart Centre Email author 

Abstract

Objectives:

Cessation of vitamin K antagonists (VKA) after a primary incidence of spontaneous venous thromboembolism (VTE) has been associated with recurrent events in about one-fifth of patients. Although long-term continuation of VKA prophylaxis has been suggested as a means to prevent recurrent VTE, concerns remain over issues of high bleeding risk, patient non-compliance as well as dosage irregularities. Antiplatelet therapy has been proposed as a safer, cheaper and more convenient alternative for long-term prophylaxis after initial treatment with VKA following VTE. Here we compare two major randomized trials that were conducted back-to-back – the WARFASA trial and the ASPIRE trial – to determine the role of aspirin as a long-term treatment option to reduce the incidence of recurrent VTE. Despite the encouraging results of these trials, suggesting that aspirin may have a beneficial effect on secondary prevention of VTE, it must be emphasized that both trials only started aspirin after 6-18 months of treatment with VKA, which remain a cornerstone of management for a first unprovoked VTE.