NEJM Audio Summary - May 24, 2012

Excerpted Script

0:56|"Aspirin for Preventing the Recurrence of Venous Thromboembolism" by Cecilia Becattini. From University of Perugia, Italy. About 20% of patients with venous thrombosis or embolism but no defined risk factors have a recurrence within the first 2 years after stopping anticoagulation therapy. This study assessed the clinical benefit of aspirin for the prevention of recurrence after a course of treatment with vitamin K antagonists in patients with unprovoked venous thromboembolism. Venous thromboembolism recurred in 28 of the 205 patients who received aspirin and in 43 of the 197 patients who received placebo (6.6% vs. 11.2% per year). During a median treatment period of 23.9 months, 23 patients taking aspirin and 39 taking placebo had a recurrence (5.9% vs. 11.0% per year). One patient in each treatment group had a major bleeding episode. Aspirin reduced the risk of recurrence when given to patients with unprovoked venous thromboembolism who had discontinued anticoagulant treatment, with no apparent increase in the risk of major bleeding.
2:13| Richard Becker, from Duke University Medical Center, Durham, North Carolina, writes in the editorial that the findings of this study are compelling and may signal an important step in the evolution of care; however, confirmatory studies will be required to establish a role in daily clinical practice for the use of aspirin among patients who are at high risk for bleeding due to anticoagulant therapy or for whom ongoing investigations identify and subsequently validate a clinical or biomarker-based profile associated with a low risk of recurring venous thromboembolism.

これをきっかけに循環器学会のHPを覗いて見ました。いつのまにか、ガイドラインが充実しています。呼吸器学会みたいに「買ってね」というのじゃないのが嬉しい。