[From apixaban to aspirin in the prevention of recurrent venous thromboembolism].

María Diez-Ewald

Index: Invest. Clin. 54(3) , 231-3, (2013)

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Abstract

For more than a decade, the only treatments available for the prevention of recurrent venous thromboembolism, were vitamin K inhibitors, or low molecular weight heparins (LMWH). Both have been very useful for this purpose; however, with the inconvenience of required frequent laboratory tests and the risk of provoking major hemorrhages. LMWH also carry the risk for immune reactions and the high cost of using it for an extended period of time. With the advent of the new anticoagulants, there is no need for laboratory tests, but there is no way to individualize the dose, or to neutralize their effect. They are also very expensive. Several recent articles have shown that aspirin, as the only treatment for the prevention of recurrent venous thromboembolism, gave good results in comparison to placebo. It has also been found that, after hip replacement surgery, the frequency of thromboembolism was similar in those patients treated with aspirin and those treated with LMWH. These results could open a new path in the search for the ideal treatment for the prevention of recurrent venous thromboembolism.