Aspirin Tops Warfarin in Clot Prevention

Aspirin is just as effective as Warfarin in preventing clots that can develop in the arteries of the lungs following joint replacement surgery, according to a study by the Rothman Institute, Philadelphia, Pennsylvania. The research was recognized as one of the best presentations at the recent American Association of Hip and Knee Surgeons meeting in Dallas. “While Warfarin is successful in the prophylactic prevention of clots it can also lead to increased bleeding, infections and hospital readmissions, ” said Javad Parvizi, M.D., director of research at the Rothman Institute and lead author on the study.

The study compared the outcomes of 26, 415 patients who underwent joint replacement surgery at the Rothman Institute between 2000 and 2011. Researchers followed 1, 824 patients who received aspirin and 24, 567 patients who received Warfarin prophylactically prior to their surgery. Both groups were monitored for up to 90 days postoperatively.

Their results showed the overall rate of pulmonary embolism to be significantly lower in the patients who received aspirin (0.2% or four in 1, 824) versus those who received Warfarin (1.0% or 92 in 9, 028). In addition, hematoma, a leakage of blood external to the blood vessel or a leakage of fluid known as a seroma, wound problems, acute infection and 90-day mortality rates were also lower in the aspirin group.

“Our study shows that aspirin is a viable alternative to Warfarin in healthy patients, with better results in preventing clots, and a lower rate of bleeding and wound complications, ” said Parvizi. “It will allow us to move away from expensive, inconvenient, and dangerous drugs in the prevention of thromboembolism after joint replacement.” He added that surgeons at the Rothman Institute at Jefferson have begun to replace Warfarin with aspirin for pre-surgical prophylactic clot prevention.