Low-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysis
Abstract Background The adverse effects of aspirin are dose-dependent, and there is controversy surrounding the use of low-dose (LD) aspirin to prevent venous thromboembolism (VTE) following total joint arthroplasty (TJA). This meta-analysis sought to compare the efficacy and complication rate of lo...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-12-01
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| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-024-05356-w |
| _version_ | 1826924491280744448 |
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| author | Peyman Mirghaderi Mohammad-Taha Pahlevan-Fallahy Payman Rahimzadeh Mohammad Amin Habibi Fatemeh Pourjoula Alireza Azarboo Alireza Moharrami |
| author_facet | Peyman Mirghaderi Mohammad-Taha Pahlevan-Fallahy Payman Rahimzadeh Mohammad Amin Habibi Fatemeh Pourjoula Alireza Azarboo Alireza Moharrami |
| author_sort | Peyman Mirghaderi |
| collection | DOAJ |
| description | Abstract Background The adverse effects of aspirin are dose-dependent, and there is controversy surrounding the use of low-dose (LD) aspirin to prevent venous thromboembolism (VTE) following total joint arthroplasty (TJA). This meta-analysis sought to compare the efficacy and complication rate of low-dose (162 mg per day) versus high-dose (HD, 650 mg per day) aspirin after TJA surgery. Methods In four main databases, we searched from inception until September 2024 for articles comparing the rate of VTE following TJA(TKA/THA) using only aspirin chemoprophylaxis with different dosages. We meta-analyzed and compared the VTE and complication rates of LD aspirin (162 mg per day) with HD aspirin (650 mg per day) and presented our results as odds ratio (ORs) in forest plot diagrams. Results There were 14 eligible studies, comprising 43,518 patients in the LD group and 62,645 patients in the HD group. DVT (OR: 1.37, CI: 0.93–2.02, P = 0.11) and PE (OR: 1.86, CI: 0.73–4.72, P = 0.19) rates were similar between the groups. However, taking VTE as the total number of cases with DVT or PE, the incidence was significantly higher in the HD group than in the LD group (OR:1.53, CI: 1.17-2.00, P = 0.002). HD also had a significantly higher rate of PJI (OR:2.68 CI:1.5–4.6 P = 0.001), but gastrointestinal bleeding (GIB) was similar between the two groups (OR: 0.97, CI: 0.42–2.22, P = 0.95). Conclusion The findings suggest that LD aspirin may be a viable option for VTE chemoprophylaxis following TJA, potentially offering comparable efficacy with a lower risk of PJI compared to HD aspirin regimens. Level of Evidence : Therapeutic Level II. |
| first_indexed | 2025-02-17T14:40:39Z |
| format | Article |
| id | doaj.art-1b6b66094bf045ccbef5682b0d0787ab |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2025-02-17T14:40:39Z |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-1b6b66094bf045ccbef5682b0d0787ab2024-12-22T12:37:03ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2024-12-0119111410.1186/s13018-024-05356-wLow-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysisPeyman Mirghaderi0Mohammad-Taha Pahlevan-Fallahy1Payman Rahimzadeh2Mohammad Amin Habibi3Fatemeh Pourjoula4Alireza Azarboo5Alireza Moharrami6Surgical Research Society (SRS), Students’ Scientific Research Center, Tehran University of Medical SciencesSurgical Research Society (SRS), Students’ Scientific Research Center, Tehran University of Medical SciencesSurgical Research Society (SRS), Students’ Scientific Research Center, Tehran University of Medical SciencesSurgical Research Society (SRS), Students’ Scientific Research Center, Tehran University of Medical SciencesSurgical Research Society (SRS), Students’ Scientific Research Center, Tehran University of Medical SciencesSurgical Research Society (SRS), Students’ Scientific Research Center, Tehran University of Medical SciencesSurgical Research Society (SRS), Students’ Scientific Research Center, Tehran University of Medical SciencesAbstract Background The adverse effects of aspirin are dose-dependent, and there is controversy surrounding the use of low-dose (LD) aspirin to prevent venous thromboembolism (VTE) following total joint arthroplasty (TJA). This meta-analysis sought to compare the efficacy and complication rate of low-dose (162 mg per day) versus high-dose (HD, 650 mg per day) aspirin after TJA surgery. Methods In four main databases, we searched from inception until September 2024 for articles comparing the rate of VTE following TJA(TKA/THA) using only aspirin chemoprophylaxis with different dosages. We meta-analyzed and compared the VTE and complication rates of LD aspirin (162 mg per day) with HD aspirin (650 mg per day) and presented our results as odds ratio (ORs) in forest plot diagrams. Results There were 14 eligible studies, comprising 43,518 patients in the LD group and 62,645 patients in the HD group. DVT (OR: 1.37, CI: 0.93–2.02, P = 0.11) and PE (OR: 1.86, CI: 0.73–4.72, P = 0.19) rates were similar between the groups. However, taking VTE as the total number of cases with DVT or PE, the incidence was significantly higher in the HD group than in the LD group (OR:1.53, CI: 1.17-2.00, P = 0.002). HD also had a significantly higher rate of PJI (OR:2.68 CI:1.5–4.6 P = 0.001), but gastrointestinal bleeding (GIB) was similar between the two groups (OR: 0.97, CI: 0.42–2.22, P = 0.95). Conclusion The findings suggest that LD aspirin may be a viable option for VTE chemoprophylaxis following TJA, potentially offering comparable efficacy with a lower risk of PJI compared to HD aspirin regimens. Level of Evidence : Therapeutic Level II.https://doi.org/10.1186/s13018-024-05356-wArthroplastyAspirinTKATHAPEVTE |
| spellingShingle | Peyman Mirghaderi Mohammad-Taha Pahlevan-Fallahy Payman Rahimzadeh Mohammad Amin Habibi Fatemeh Pourjoula Alireza Azarboo Alireza Moharrami Low-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysis Journal of Orthopaedic Surgery and Research Arthroplasty Aspirin TKA THA PE VTE |
| title | Low-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysis |
| title_full | Low-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysis |
| title_fullStr | Low-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysis |
| title_full_unstemmed | Low-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysis |
| title_short | Low-versus high-dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty: a systematic review and meta-analysis |
| title_sort | low versus high dose aspirin for venous thromboembolic prophylaxis after total joint arthroplasty a systematic review and meta analysis |
| topic | Arthroplasty Aspirin TKA THA PE VTE |
| url | https://doi.org/10.1186/s13018-024-05356-w |
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