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Does acetyl salicylic acid (ASA) have a role in the prevention of venous thromboembolism?

  1. Ganesan Karthikeyan1,2,
  2. John W. Eikelboom2,
  3. Alexander G. G. Turpie2,
  4. Jack Hirsh3

Article first published online: 12 MAY 2009

DOI: 10.1111/j.1365-2141.2009.07734.x

Issue

British Journal of Haematology

British Journal of Haematology

Volume 146, Issue 2, pages 142–149, July 2009

Additional Information

How to Cite

Karthikeyan, G., Eikelboom, J. W., Turpie, A. G. G. and Hirsh, J. (2009), Does acetyl salicylic acid (ASA) have a role in the prevention of venous thromboembolism?. British Journal of Haematology, 146: 142–149. doi: 10.1111/j.1365-2141.2009.07734.x

Author Information

  1. 1

    All India Institute of Medical Sciences, New Delhi, India

  2. 2

    Hamilton General Hospital, McMaster University, Hamilton, ON

  3. 3

    Henderson Hospital Site, McMaster University, Hamilton, ON, Canada

*Dr Ganesan Karthikeyan MD, DM, Department of Medicine and Population Health Research Institute, Hamilton General Hospital, 237, Barton Street East, Hamilton, ON, Canada L8L 2X2 and Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India – 110029. E-mail: karthik2010@gmail.com

Publication History

  1. Issue published online: 1 JUL 2009
  2. Article first published online: 12 MAY 2009

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Keywords:

  • acetyl salicylic acid;
  • aspirin;
  • deep venous thrombosis;
  • pulmonary thromboembolism;
  • venous thromboembolism

Summary

Guidelines differ on whether acetyl salicylic acid (ASA, aspirin) should be used for prophylaxis in patients at high-risk of venous thromboembolism (VTE), principally because of differences in perceptions of its efficacy. ASA is an attractive therapeutic option because it is inexpensive, easy to administer and does not require monitoring. We critically reappraised the evidence from randomized controlled trials for the efficacy of ASA in VTE prevention. ASA is clearly efficacious in preventing VTE compared to placebo or no treatment, but appears to be less efficacious than the low molecular weight heparins in small trials. There is little data for ASA in comparison with unfractionated heparin and warfarin. A large randomized controlled trial is required to clarify the role of ASA compared to contemporary anticoagulant strategies for the prevention of VTE.

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