When people have knee or hip replacement surgery, they may face the danger of blood clot formation. Such clots can form in the large veins of the legs, break loose and end up in the lungs as pulmonary embolisms. If this happens, it is a life-threatening complication. That’s why doctors often prescribe anticoagulants following surgery. How does aspirin compare to other anticoagulants in this situation?
Aspirin vs Pricey Anticoagulants:
A new study compared pricey anticoagulants such as rivaroxaban or dabigatran to inexpensive aspirin (JAMA Internal Medicine, online Feb. 3, 2020). There were 13 randomized controlled trials in this meta-analysis and systematic review. More than 6,000 people participated in these trials.
The investigators analyzed the data for evidence of any deep vein thrombosis after surgery. Abbreviated DVT, deep vein thrombosis is the medical term for a dangerous blood clot. How well did aspirin compare in effectiveness and safety?
They found that:
“The effectiveness and safety of aspirin did not appear to have been statistically significantly different from other anticoagulants used for venous thromboembolism prophylaxis after total hip and knee replacement and hence remains an option for use.”
The authors call for larger studies to determine whether more expensive anticoagulants sold as Pradaxa or Xarelto are any safer or more effective than aspirin. What we know for sure is that they are more expensive.
Other Studies Compare Aspirin to Anticoagulants After Surgery:
In summary, this is not the first study to compare aspirin to other anticoagulants for preventing post-operative blood clots. Unfortunately, researchers have not devoted enough attention to the question of whether discontinuing low-dose aspirin before surgery increases risk. This is truly a serious dilemma, since staying on aspirin through surgery might increase the chance of excessive bleeding.