Find out if aspirin reigns over the powerful blood thinner Coumadin for blood clot prevention following joint replacement surgery.
Typically prior to joint replacement surgery, the patient is given Coumadin (warfarin), a powerful blood thinner, to help prevent development of blood clots during and after surgery.
These blood clots are also known as deep vein thromboses (DVT), and can migrate to the lungs and become a pulmonary embolus: a very life-threatening situation.
The Rothman Institute at Jefferson conducted a study showing that aspirin is at least as effective in blood clot prevention as is Coumadin, and more effective in other ways.
You may be wondering, though, why not just stick with Coumadin, since this is more powerful?
Well, that’s the problem; as a blood thinner, Coumadin can do its job too well.
“While warfarin is successful in the prophylactic prevention of clots, it can also lead to increased bleeding,” explains Javad Parvizi, MD, lead investigator, and director of research at the Rothman Institute.
He adds that Coumadin can also lead to infections and readmissions to the hospital.
My father has had three joint replacements, and each time, had to take Coumadin leading up to the surgery, but did not have any complications from the drug.
The Rothman study is very compelling because it compared outcomes of over 26,000 patients who had joint replacement surgery at the Institute.
Over 1,800 received aspirin prior to their joint replacement surgery, and over 24,000 received Coumadin prior to their joint replacement procedure. Both groups received monitoring for up to three months post-surgery.
Point two percent of the aspirin patients developed a pulmonary embolism. And one percent of the Coumadin group developed a pulmonary embolism.
The difference between point two percent and one percent is very statistically significant.
The difference between aspirin and Coumadin doesn’t end there. Hematoma (a type of blood leakage) and seroma (fluid leakage), plus wound issues, acute infection and 90-day mortality rates were actually lower in the aspirin group.
“Our study shows that aspirin is a viable alternative to warfarin in healthy patients,” says Dr. Parvizi, “with better results in preventing clots, and a lower rate of bleeding and wound complications.”
If you’re facing joint replacement surgery, ask your surgeon about aspirin and tell him or her about this study.
