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About one in 10 people who suffer a venous thromboembolism (VTE) experience a recurrence in the year after discontinuing anticoagulants. Now Circulation reports that aspirin may cut recurrences by more than a third without significantly increasing bleeding risk.

Researchers analysed data collected during the Warfarin and Aspirin (WARFASA) and the Aspirin to Prevent Recurrent Venous Thromboembolism (ASPIRE) studies to compare the effect of aspirin and placebo on recurrent VTE, major vascular events (e.g. myocardial infarction, stroke and deaths from cardiovascular disease) and bleeding.

Of the 1,224 patients studied, 193 experienced recurrent VTE during the median 30.4 months follow-up. Major bleeding rates were low with placebo and aspirin (0.4 and 0.5 per cent a year respectively). Overall, aspirin reduced the risk of recurrent VTE by 32 per cent (7.5 versus 5.1 per cent a year respectively), including a 34 per cent reduction in deep vein thrombosis and pulmonary embolism.

In addition, aspirin reduced major vascular events compared to placebo (5.7 and 8.7 per cent per year respectively) by 34 per cent. After adjusting for adherence, aspirin reduced recurrent VTE by 42 per cent. Men and older people showed similar relative, but larger absolute, reductions. Overall, 31 patients need to take aspirin for one year to prevent one VTE.