title: Tranexamic Acid Can Be Administered to Arthroplasty Patients Who Receive Aspirin for Venous Thromboembolic Prophylaxis.
abstract: Venous thromboembolism (VTE) is not uncommon after total joint arthroplasty (TJA). Various prophylactic agents have been used to minimize this complication after TJA. Numerous studies have demonstrated that acetylsalicylic acid (ASA) has equivalent efficacy to other agents in preventing VTE after TJA. However, some have expressed theoretical concern that ASA may not be an adequate VTE prophylaxis in TJA patients receiving tranexamic acid (TA), which is an antifibrinolytic agent. The purpose of the study was to assess the safety and efficacy of administering systemic TA in TJA patients who also received ASA for VTE prophylaxis.
  
  
  
  A retrospective study was conducted on 2835 consecutive patients (1678 receiving TA and 1157 not receiving TA) who underwent primary or revision TJA between January 2013 and June 2014 and also received aspirin for VTE prophylaxis. The incidence of symptomatic deep vein thrombosis and pulmonary embolism was evaluated.
  
  
  
  Blood loss and transfusion rates were significantly lower in the TA group compared to the non-TA group (P < .0001, P = .017, respectively). The incidence of VTE, bleeding events, and wound complications was similar (P > .05) between the groups.
  
  
  
  In patients undergoing TJA who receive ASA for VTE prophylaxis, TA reduces bleeding and transfusions without increasing the incidence of subsequent VTE.
authors.affiliation: Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Snir
authors.initials: S
authors.lastname: Heller
authors.affiliation: Department of Orthopaedic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Eric
authors.initials: E
authors.lastname: Secrist
authors.affiliation: Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Alisina
authors.initials: A
authors.lastname: Shahi
authors.affiliation: Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Antonia F
authors.initials: AF
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Surgery, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Javad
authors.initials: J
authors.lastname: Parvizi
mesh_terms: D000368:Aged; D000933:Antifibrinolytic Agents / Q000627:therapeutic use; D001178:Arthroplasty / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000453:epidemiology / Q000517:prevention & control*; D012189:Retrospective Studies; D014148:Tranexamic Acid / Q000008:administration & dosage*; D065227:Transfusion Reaction; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000209:etiology / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000517:prevention & control
chemical_list: D000933:Antifibrinolytic Agents; D014148:Tranexamic Acid; D001241:Aspirin
keywords: aspirin; pulmonary embolism; total joint arthroplasty; tranexamic acid; venous thromboembolism