| Low-dose aspirin for preventing recurrent venous thromboembolism. | |
| | |
MedLine Citation:
|
PMID: 23121403 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Patients who have had a first episode of unprovoked venous thromboembolism have a high risk of recurrence after anticoagulants are discontinued. Aspirin may be effective in preventing a recurrence of venous thromboembolism. METHODS: We randomly assigned 822 patients who had completed initial anticoagulant therapy after a first episode of unprovoked venous thromboembolism to receive aspirin, at a dose of 100 mg daily, or placebo for up to 4 years. The primary outcome was a recurrence of venous thromboembolism. RESULTS: During a median follow-up period of 37.2 months, venous thromboembolism recurred in 73 of 411 patients assigned to placebo and in 57 of 411 assigned to aspirin (a rate of 6.5% per year vs. 4.8% per year; hazard ratio with aspirin, 0.74; 95% confidence interval [CI], 0.52 to 1.05; P=0.09). Aspirin reduced the rate of the two prespecified secondary composite outcomes: the rate of venous thromboembolism, myocardial infarction, stroke, or cardiovascular death was reduced by 34% (a rate of 8.0% per year with placebo vs. 5.2% per year with aspirin; hazard ratio with aspirin, 0.66; 95% CI, 0.48 to 0.92; P=0.01), and the rate of venous thromboembolism, myocardial infarction, stroke, major bleeding, or death from any cause was reduced by 33% (hazard ratio, 0.67; 95% CI, 0.49 to 0.91; P=0.01). There was no significant between-group difference in the rates of major or clinically relevant nonmajor bleeding episodes (rate of 0.6% per year with placebo vs. 1.1% per year with aspirin, P=0.22) or serious adverse events. CONCLUSIONS: In this study, aspirin, as compared with placebo, did not significantly reduce the rate of recurrence of venous thromboembolism but resulted in a significant reduction in the rate of major vascular events, with improved net clinical benefit. These results substantiate earlier evidence of a therapeutic benefit of aspirin when it is given to patients after initial anticoagulant therapy for a first episode of unprovoked venous thromboembolism. (Funded by National Health and Medical Research Council [Australia] and others; Australian New Zealand Clinical Trials Registry number, ACTRN12605000004662.). |
| | |
Authors:
|
Timothy A Brighton; John W Eikelboom; Kristy Mann; Rebecca Mister; Alexander Gallus; Paul Ockelford; Harry Gibbs; Wendy Hague; Denis Xavier; Rafael Diaz; Adrienne Kirby; John Simes; |
Related Documents
:
|
11884873 - Factors associated with reduced visual acuity during long-term follow-up of patients wi... 15389273 - Long-term treatment of refractory posterior uveitis with anti-tnfalpha (infliximab). 23164593 - Intravascular ultrasound assessed incomplete stent apposition and stent fracture in ste... |
Publication Detail:
|
Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2012-11-04 |
Journal Detail:
|
Title: The New England journal of medicine Volume: 367 ISSN: 1533-4406 ISO Abbreviation: N. Engl. J. Med. Publication Date: 2012 Nov |
Date Detail:
|
Created Date: 2012-11-22 Completed Date: 2012-12-05 Revised Date: 2013-04-26 |
Medline Journal Info:
|
Nlm Unique ID: 0255562 Medline TA: N Engl J Med Country: United States |
Other Details:
|
Languages: eng Pagination: 1979-87 Citation Subset: AIM; IM |
Affiliation:
|
Department of Haematology, South Eastern Area Laboratory Services (SEALS), Prince of Wales Hospital, Sydney, Australia. aspire@ctc.usyd.edu.au |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aspirin
/
administration & dosage*,
adverse effects,
therapeutic use Double-Blind Method Female Follow-Up Studies Hemorrhage / chemically induced, epidemiology Humans Incidence Male Middle Aged Platelet Aggregation Inhibitors / administration & dosage*, adverse effects, therapeutic use Recurrence / prevention & control Risk Venous Thromboembolism / epidemiology, prevention & control* |
| Chemical | |
Reg. No./Substance:
|
0/Platelet Aggregation Inhibitors; 50-78-2/Aspirin |
| Investigator | |
Investigator/Affiliation:
|
T Brighton / ; J Eikelboom / ; W Hague / ; A Kirby / ; R Mister / ; J Simes / ; A Gallus / ; P Ockelford / ; R Baker / ; H Gibbs / ; P Coughlin / ; D Xavier / ; R Diaz / ; G Agnelli / ; H Gibbs / ; T Karplus / ; J Fletcher / ; A van Rij / ; Anthony Rogers / ; C Hayward / ; Graham Young / ; P Crispin / ; J Slade / ; C Ward / ; N Tadayon / ; J Koutts / ; L Fisher / ; T Brighton / ; K McCardie / ; A Bianchi / ; J Trinh / ; J Joseph / ; P Plenge / ; B Chong / ; S Davidson / ; J Waites / ; P Cahill / ; C Tiley / ; M Lacey / ; D Jackson / ; J Boys / ; M Seldon / ; M Gambrill / ; H Nandurkar / ; H Worland / ; H Salem / ; C Gollogly / ; P Campbell / ; I Marshall / ; K Hamilton / ; C Goss / ; H Salem / ; L Poulton / ; M Jackson / ; T de Man / ; E Gan / ; A Cummins / ; M Leyden / ; C Sturtz / ; P Kubler / ; X Sansome / ; A McCann / ; C Downey / ; P Carroll / ; M Duroux / ; S Hamwood / ; G Styles / ; N Buckmaster / ; T Schmidt / ; D Colquhoun / ; A Jardim / ; A Gallus / ; J Osmond / ; W Jeffries / ; B Trezona / ; S McRae / ; D King / ; R Baker / ; K Courtley / ; R Kimber / ; L Oliver / ; A MacDonald / ; J Shepherd / ; P Ockelford / ; M Hulton / ; G Royle / ; L Haycock / ; D Simpson / ; K Yap / ; B Baker / ; H McQuilkin / ; J Carter / ; J Body / ; L Lai Heng / ; M Tan / ; J Chin Tay / ; J Zou / ; H Kumar Pandharpurkar / ; Remya G / ; E Stephen / ; A Benjamin / ; S C Desai / ; R Singh / ; K R Suresh / ; Girija K R / ; S Natarajan / ; D Goel / ; R Gupta / ; B S Mishra / ; G Sidhu / ; R Singh Sidhu / ; R Parakh / ; R Sharma / ; S Joshi / ; M Mahajan / ; T Grover / ; K Sharma / ; P Patel / ; A Kothurkar / ; P Ranade / ; J L Fedele / ; A C Cristófaro / ; E Gelersztein / ; M Gelersztein / ; A S Sánchez / ; L C Bowen / ; R O García Durán / ; F Cámpora / ; H Héctor Ferro / ; M V Casais / ; R Mister / ; A Kirby / ; K Mann / ; C Van Holst Pellekaan / ; S Chinchen / ; A Lucas / ; W Hague / ; J Simes / ; D Xavier / ; P Pais / ; A Sigamani / ; N Mathur / ; Anupama M / ; Deepthi K B / ; R Diaz / ; C Chacon / ; R Rucci / |
| Comments/Corrections | |
Comment In:
|
Dtsch Med Wochenschr. 2013 Feb;138(6):244
[PMID:
23479792
]
Nat Rev Cardiol. 2013 Jan;10(1):4 [PMID: 23165071 ] N Engl J Med. 2012 Nov 22;367(21):2039-41 [PMID: 23121404 ] N Engl J Med. 2013 Feb 21;368(8):773 [PMID: 23425172 ] N Engl J Med. 2013 Feb 21;368(8):772-3 [PMID: 23425174 ] N Engl J Med. 2013 Feb 21;368(8):772 [PMID: 23425173 ] Ann Intern Med. 2013 Mar 19;158(6):JC2 [PMID: 23552619 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: An indole-derivative protects against acetaminophen-induced liver injury by directly binding to N-ac...
Next Document: Aspirin for Dual Prevention of Venous and Arterial Thrombosis.