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Aspirin therapy following provoked or unprovoked DVT

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    Tyrell Wadsworth, Medical Writer and Contributor to Vein News and www. VeinsVeinsVeins.com 

    Is there a role for aspirin therapy in the prevention of recurrent venous thromboembolism in patients with first episode of unprovoked DVT or pulmonary embolism ? 

    What is an unprovoked DVT ? 

    The term unprovoked deep vein thrombosis (DVT) implies that no identifiable provoking environmental event for DVT is evident.

    What is a provoked DVT ? 

    A provoked DVT is one that is usually caused by a known event (eg, surgery, hospital admission, cancer, Covid-19 infection).

    What is the data ? 

    Two randomized trials have compared aspirin with placebo for the prevention of recurrent VTE in patients with a first unprovoked proximal DVT or PE who have completed 3 to 18 months of anticoagulant therapy.

    These trials provide moderate-quality evidence that extended aspirin therapy reduces recurrent VTE by about one-third.

    in these trials, the benefits of aspirin outweighed the increase in bleeding, which was not statistically significant.

    • Brighton TA, Eikelboom JW, Mann K et al.  Low-dose aspirin for preventing recurrent venous thromboembolism.  NEJM 2012; 367: 1979-1987
    Becattini C, Agnelli G, Schenone A et al.  Aspirin for preventing the recurrene of venous thromboembolism.  NEJM 2012; 366: 1959-1967.

    Simes J, Becattini C, Agnell G et al. Aspirin for the prevention of recurrent venous thromboembolism : The INSPIRE Collaboration. Circulation 2014; 132: 1060-1072.