Effect of aspirin vs enoxaparin on VTE after total hip, knee arthroplasty

Editor's Note

This study (CRISTAL randomized trial) from Australia finds that aspirin compared with enoxaparin resulted in significantly higher rates of venous thromboembolism (VTE) after total hip or knee arthroplasty.

This cluster-randomized, crossover trial included 9,711 patients in 31 hospitals in Australia—5,675 in the aspirin group and 4,036 in the enoxaparin group. Hospitals were randomized to administer aspirin (100 mg/day) or enoxaparin (40 mg/day) for 35 days after total hip and for 14 days after total knee arthroplasties.

The researchers found that treatment with aspirin vs enoxaparin resulted in statistically significant higher rates of symptomatic VTE (including below-knee VTE) within 90 days after total hip or knee arthroplasty—3.45% vs 1.82% of patients, respectively. Secondary outcomes were similar between groups.

A cost-effectiveness analysis is needed to better understand the clinical relevance of the findings, the researchers say.