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Evidence summaries

Reduction of Venous Thrombosis and Pulmonary Embolism by Antiplatelet Prophylaxis Among Surgical and Medical Patients

Antiplatelet prophylaxis reduces the incidence of deep venous thrombosis and pulmonary embolism in surgical and medical patients. Level of evidence: "A"

A systematic review 1 on antiplatelet drugs (aspirin, flurbiprofen, ibuprofen, naproxen, sulphinpyrazone, triflusal, dipyridamole, suloctidil, hydroxychloroquine, dazoxiben, piracetman, picotamide, ridogrel, sultroban, daltroban, ticlodipine) including 53 studies on deep venous thrombosis (n=5708) and 62 studies on pulmonary embolism (n=9446) was abstracted in DARE. Deep venous thrombosis was diagnosed by venography or fibrinogen uptake tests. For the verification of pulmonary embolism, any method was accepted.

The odds of deep venous thrombosis were reduced from 33.6% (controls) to 24.8% (antiplatelet groups), benefiting 90 patients per 1000 treated. The odds of pulmonary embolism were reduced from 2.7% (control) to 1.0% (antiplatelet groups) benefiting 17 patients per 1000 patients treated. Overall there were fewer deaths on antiplatelet drugs (0.7%) compared to control (1.0%), but this difference was not statistically significant.

Comment: The review fulfilled high methodological standards. In clinical practice, low molecular weightheparin is generally used if prophylaxis of venous trombosis is indicated.

References

  • Collaborative overview of randomised trials of antiplatelet therapy--III: Reduction in venous thrombosis and pulmonary embolism by antiplatelet prophylaxis among surgical and medical patients. Antiplatelet Trialists' Collaboration. BMJ 1994 Jan 22;308(6923):235-46. [PubMed][DARE]

Primary/Secondary Keywords