[What is the place of aspirin in venous thrombosis prophylaxis?].
Since Virchow triade, it is well established that venous thrombosis is a multifactorial process involving various cellular and plasmatic protagonists. Aspirin antihrombotic efficacy seems not only due to its antiplatelet effects and thromboxane A2 synthesis inhibition. Anti-Platelet Trialists Collaboration metaanalysis stressed in 1994 the interest of aspirin treatment leading to 40% reduction of thrombosis relative risk. Regarding studies heterogeneity and outcomes criteria variety, its use in such context remains a matter of debate. Is the recent publication of PEP trial showing a significant decrease of pulmonary embolism mortality (0.6 versus 0.3%, p = 0.03) able to reinforce aspirin use in venous thrombosis prophylaxis? Were numerous and consecutive criticisms justified? Is there still a potential indication for aspirin in this setting? The experts of the last ACCP consensus conference recommended not to recommend aspirin in venous thrombosis prophylaxis with the highest level of evidence (grade A).
Elalamy
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Service d'hématologie biologique, Hôtel-Dieu, place du parvis-Notre-Dame, 75181 Paris, France. ismail.elalamy@htd.ap-hop-paris.fr
Hatmi
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D001241:Aspirin / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D017410:Practice Guidelines as Topic; D011655:Pulmonary Embolism / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control*
D005343:Fibrinolytic Agents; D001241:Aspirin