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Meta-Analysis
. 2022 Jul 25;7(7):CD012369.
doi: 10.1002/14651858.CD012369.pub2.

Antiplatelet agents for the treatment of deep venous thrombosis

Carolina Dq Flumignan  1   2 , Luis Cu Nakano  1   2 , Jose Cc Baptista-Silva  1   2 , Ronald Lg Flumignan  1   2
Affiliations
Meta-Analysis

Antiplatelet agents for the treatment of deep venous thrombosis

Carolina Dq Flumignan et al. Cochrane Database Syst Rev. .

Abstract

Background: Antiplatelet agents may be useful for the treatment of deep venous thrombosis (DVT) when used in addition to best medical practice (BMP), which includes anticoagulation, compression stockings, and clinical care such as physical exercise, skin hydration, etc. Antiplatelet agents could minimise complications such as post-thrombotic syndrome (PTS) and pulmonary embolism (PE). They may also reduce the recurrence of the disease (recurrent venous thromboembolism (recurrent VTE)). However, antiplatelet agents may increase the likelihood of bleeding events.

Objectives: To assess the effects of antiplatelet agents in addition to current BMP compared to current BMP (with or without placebo) for the treatment of DVT.

Search methods: The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase and CINAHL databases and World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials registers to 7 December 2021. The review authors searched LILACS and IBECS databases (15 December 2021) and also checked the bibliographies of included trials for further references to relevant trials, and contacted specialists in the field, manufacturers and authors of the included trials.

Selection criteria: We considered randomised controlled trials (RCTs) examining antiplatelet agents compared to BMP following initial standard anticoagulation treatment for DVT. We included studies where antiplatelet agents were given in addition to current BMP compared to current BMP (with or without placebo) for the treatment of DVT (acute: treatment started within 21 days of symptom onset; chronic: treatment started after 21 days of symptom onset). We evaluated only RCTs where the antiplatelet agents were the unique difference between the groups (intervention and control).

Data collection and analysis: We used standard Cochrane methodological procedures. Two review authors independently extracted data and assessed risk of bias of the trials. Any disagreements were resolved by discussion with a third review author. We calculated outcome effects using risk ratio (RR) or mean difference (MD) with a 95% confidence interval (CI) and the number needed to treat to benefit (NNTB).

Main results: We included six studies with 1625 eligible participants, with data up to 37.2 months of follow-up. For one preplanned comparison (i.e. antiplatelet agents plus BMP versus BMP plus placebo) for acute DVT we identified no eligible studies for inclusion. In acute DVT, antiplatelet agents plus BMP versus BMP alone was assessed by one study (500 participants), which reported on four outcomes until 6 months of follow-up. There were no deaths and no cases of major bleeding reported. The participants who received antiplatelet agents showed a lower risk of PTS (RR 0.74, 95% CI 0.61 to 0.91; 1 study, 500 participants; very low-certainty evidence). The control group presented a lower risk of adverse events compared to the intervention group (RR 2.88, 95% CI 1.06 to 7.80; 1 study, 500 participants; very low-certainty evidence). This study did not provide information for recurrent VTE or PE. In chronic DVT, antiplatelet agents plus BMP versus BMP alone was assessed by one study (224 participants). The study authors reported four relevant outcomes, three of which (major bleeding, mortality and adverse events) showed no events during the 3 years of follow-up. Therefore, an effect estimate could only be reported for recurrent VTE, favouring antiplatelet agents plus BMP versus BMP alone (RR 0.12, 95% CI 0.05 to 0.34; 1 study, 224 participants; very low-certainty evidence). For the outcomes PE and PTS, this study did not present information which could be used for analysis. In chronic DVT, antiplatelet agents plus BMP versus BMP plus placebo was assessed by four studies (901 participants). The meta-analysis of this pooled data showed a lower risk of recurrent VTE for the antiplatelet agents group (RR 0.65, 95%, CI 0.43 to 0.96; NNTB = 14; low-certainty evidence). For major bleeding, we found no clear difference between placebo and intervention groups until 37.2 months of follow-up (RR 0.98, 95% CI 0.29 to 3.34; 1 study, 583 participants; moderate-certainty evidence). In PE fatal/non-fatal outcome, we found no clear difference with the use of antiplatelet agents (RR 0.52, 95% CI 0.23 to 1.14; 1 study, 583 participants; moderate-certainty evidence). For all-cause mortality, the overall effect of antiplatelet agents did not differ from the placebo group (RR 0.48, 95% CI 0.21 to 1.06; 3 studies, 649 participants; moderate-certainty evidence). The adverse events outcome did not show a clear difference (RR 1.57, 95% CI 0.34 to 7.19; 2 studies, 621 participants; moderate-certainty evidence). There is no assessment of PTS in these studies. We downgraded the certainty of evidence for risk of bias, indirectness, imprecision and publication bias.

Authors' conclusions: In chronic DVT settings, following the initial standard treatment with anticoagulants, there is low-certainty evidence that antiplatelet agents in addition to BMP may reduce recurrent VTE, (NNTB = 14) when compared to BMP plus placebo. Moderate-certainty evidence shows no clear difference in adverse events, major bleeding and PE when antiplatelet agents are used in addition to BMP compared to BMP plus placebo. In acute and chronic DVT settings, following the initial standard treatment with anticoagulants, we can draw no conclusions for antiplatelet agents in addition to BMP compared to BMP alone due to very low-certainty evidence. Trials of high methodological quality, that are large and of sufficient duration to detect significant clinical outcomes are needed. Trials should ideally last more than 4 years in order to estimate the long-term effect of antiplatelet agents. Trials should include people with acute and chronic DVT and provide relevant individual data, such as the outcome for each index event (DVT or PE), the use of an inferior vena cava (IVC) filter, whether the DVT is provoked or unprovoked, and the age of participants.

Trial registration: ClinicalTrials.gov NCT00222677 NCT02064439.

PubMed Disclaimer

Conflict of interest statement

CDQF: none known LCUN: none known JCCBS: none known RLGF: none known

Figures

1
1
Study flow diagram.
2
2
Risk of bias graph: 'Review authors' judgements about each risk of bias item presented as percentages across all included studies.
3
3
Risk of bias summary: 'Review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1: Acute DVT ‐ antiplatelet agents plus BMP versus BMP alone, Outcome 1: Major bleeding
1.2
1.2. Analysis
Comparison 1: Acute DVT ‐ antiplatelet agents plus BMP versus BMP alone, Outcome 2: Mortality
1.3
1.3. Analysis
Comparison 1: Acute DVT ‐ antiplatelet agents plus BMP versus BMP alone, Outcome 3: Post‐thrombotic syndrome
1.4
1.4. Analysis
Comparison 1: Acute DVT ‐ antiplatelet agents plus BMP versus BMP alone, Outcome 4: Post‐thrombotic syndrome
1.5
1.5. Analysis
Comparison 1: Acute DVT ‐ antiplatelet agents plus BMP versus BMP alone, Outcome 5: Adverse events
1.6
1.6. Analysis
Comparison 1: Acute DVT ‐ antiplatelet agents plus BMP versus BMP alone, Outcome 6: Adverse events
2.1
2.1. Analysis
Comparison 2: Chronic DVT ‐ antiplatelet agents plus BMP versus BMP alone, Outcome 1: Recurrent VTE
2.2
2.2. Analysis
Comparison 2: Chronic DVT ‐ antiplatelet agents plus BMP versus BMP alone, Outcome 2: Major bleeding
2.3
2.3. Analysis
Comparison 2: Chronic DVT ‐ antiplatelet agents plus BMP versus BMP alone, Outcome 3: Mortality
2.4
2.4. Analysis
Comparison 2: Chronic DVT ‐ antiplatelet agents plus BMP versus BMP alone, Outcome 4: Adverse events
3.1
3.1. Analysis
Comparison 3: Chronic DVT ‐ antiplatelet agents plus BMP versus BMP plus placebo, Outcome 1: Recurrent VTE
3.2
3.2. Analysis
Comparison 3: Chronic DVT ‐ antiplatelet agents plus BMP versus BMP plus placebo, Outcome 2: Major bleeding
3.3
3.3. Analysis
Comparison 3: Chronic DVT ‐ antiplatelet agents plus BMP versus BMP plus placebo, Outcome 3: PE (fatal/nonfatal)
3.4
3.4. Analysis
Comparison 3: Chronic DVT ‐ antiplatelet agents plus BMP versus BMP plus placebo, Outcome 4: Mortality
3.5
3.5. Analysis
Comparison 3: Chronic DVT ‐ antiplatelet agents plus BMP versus BMP plus placebo, Outcome 5: Adverse events
3.6
3.6. Analysis
Comparison 3: Chronic DVT ‐ antiplatelet agents plus BMP versus BMP plus placebo, Outcome 6: Duration of hospitalisation (days)
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References

References to studies included in this review

ASPIRE {published and unpublished data}
    1. ACTRN012605000004662. ASPIRE A multi-centre, randomised, double-blind, placebo-controlled clinical trial examining the efficacy and safety of low-dose aspirin after initial anticoagulation to prevent recurrent venous thromboembolism. ctc.usyd.edu.au/our-work/research-divisions/cardiovascular/closed-trials... (first received 1 May 2003).
    1. ACTRN12605000004662. ASPIRE. A multi-centre, randomised, double-blind, placebo-controlled clinical trial examining the efficacy and safety of low-dose aspirin after initial anticoagulation to prevent recurrent venous thromboembolism. trialsearch.who.int/?trialid=ACTRN12605000004662 (first received 12 July 2005).
    1. ACTRN12605000004662. ASPIRE A multi-centre, randomised, double-blind, placebo-controlled clinical trial examining the efficacy and safety of low-dose aspirin after initial anticoagulation to prevent recurrent venous thromboembolism. anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12605000004662 (first received 12 July 2005).
    1. Brighton T, Eikelboom J, Mann K, Mister R, Gallus A, Ockelford Petal. Aspirin for the prevention of recurrent venous thromboembolism after a first unprovoked event: results of the ASPIRE randomized controlled trial. In: Late-Breaking Clinical Trial Abstracts. Circulation 2012;126(23):2777. [DOI: 10.1161/CIR.0b013e318278c90d] - DOI
    1. Brighton TA, Eikelboom JW, Mann K, Mister R, Gallus A, Ockelford P, et al. Low-dose aspirin for preventing recurrent venous thromboembolism. New England Journal of Medicine 2012;367(21):1979-87. [DOI: 10.1056/NEJMoa1210384] - DOI - PubMed
Indobufen 1993 {published data only (unpublished sought but not used)}
    1. Belcaro G, Errichi BM, De Simone P. Prevention of recurrent deep venous thrombosis with indobufen. A 3-year follow-up study using color duplex scanning. Angiology 1993;44(4):328-31. [PMID: ] - PubMed
    1. Belcaro G, Laurora G, Cesarone MR, De Sanctis MT. Prophylaxis of recurrent deep venous thrombosis. A randomized, prospective study using indobufen and graduated elastic compression stockings. Angiology 1993;44(9):695-9. [PMID: ] - PubMed
Moriau 1995 {published data only (unpublished sought but not used)}
    1. Moriau M, Lavenne-Pardonge E, Crasborn L, Frenckell R, Col-Debeys C. The treatment of severe or recurrent deep venous thrombosis. Beneficial effect of the co-administration of antiplatelet agents with or without rheological effects, and anticoagulants. Thrombosis Research 1995;78(6):469-82. [PMID: ] - PubMed
Steele 1980 {published data only (unpublished sought but not used)}
    1. Steele P. Trial of dipyridamole-aspirin in recurring venous thrombosis. Lancet (London, England) 1980;2(8208-8209):1328-9. [PMID: ] - PubMed
Sulfinpyrazone 1978 {published data only (unpublished sought but not used)}
    1. Steele P, Ellis J Jr, Genton E. Effects of platelet suppressant, anticoagulant and fibrinolytic therapy in patients with recurrent venous thrombosis. American Journal of Medicine 1978;64(3):441-5. [PMID: ] - PubMed
WARFASA {published data only (unpublished sought but not used)}
    1. Becattini C, Agnelli G, Poggio R, Eichinger S, Bucherini E, Silingardi M, et al. Aspirin after oral anticoagulants for prevention of recurrence in patients with unprovoked venous thromboembolism. the WARFASA study. Blood 2011;118(21):543. [online ISSN: 1528-0020]
    1. Becattini C, Agnelli G, Schenone A, Eichinger S, Bucherini E, Silingardi M, et al. Aspirin for preventing the recurrence of venous thromboembolism: correction. New England Journal of Medicine 2012;367(16):1573. [DOI: 10.1056/NEJMx120070] - DOI - PubMed
    1. Becattini C, Agnelli G, Schenone A, Eichinger S, Bucherini E, Silingardi M, et al. Aspirin for preventing the recurrence of venous thromboembolism. New England Journal of Medicine 2012;366(21):1959-67. [DOI: 10.1056/NEJMoa1114238] - DOI - PubMed
    1. Becattini C, Agnelli G, Schenone A, Eichinger S, Bucherini E, Silingardi M, et al. Supplementary appendix to 'Aspirin for preventing the recurrence of venous thromboembolism'. www.nejm.org/doi/suppl/10.1056/NEJMoa1114238/suppl_file/nejmoa1114238_ap... 2012;(accessed 7 January 2017). - PubMed
    1. NCT00222677. Aspirin after six months or one year of oral anticoagulants for the prevention of recurrent venous thromboembolism in patients with idiopathic venous thromboembolism. The WARFASA Study. clinicaltrials.gov/ct2/show/NCT00222677 (first received 22 September 2005).

References to studies excluded from this review

Bick 1981 {published data only}
    1. Bick RL, Nix MK, Skondia V. THe effect of piracetam in preventing recurrent deep venous thrombosis. Thrombosis and Haemostasis 1981;46(1):91. [ISSN 0340-6245]
EINSTEIN CHOICE {published data only}
    1. EUCTR2013-000619-26. Reduced-dosed rivaroxaban and standard-dosed rivaroxaban versus ASA in the long-term prevention of recurrent symptomatic venous thromboembolism in patients with symptomatic deep-vein thrombosis and/or pulmonary embolism (The Einstein Choice Study). clinicaltrialsregister.eu/ctr-search/trial/2013-000619-26/AT (first received 12 February 2014).
    1. EUCTR2013-000619-26-HU. Reduced-dosed rivaroxaban and standard-dosed rivaroxaban versus ASA in the long-term prevention of recurrent symptomatic venous thromboembolism in patients with symptomatic deep-vein thrombosis and/or pulmonary embolism. The Einstein Choice Study - Reduced-dosed rivaroxaban in the long-term prevention of recurrent symptomatic VTE. trialsearch.who.int/?trialid=EUCTR2013-000619-26-HU (first received 11 March 2014).
    1. NCT02064439. Reduced-dosed rivaroxaban and standard-dosed rivaroxaban versus ASA in the long-term prevention of recurrent symptomatic venous thromboembolism in patients with symptomatic deep-vein thrombosis and/or pulmonary embolism. clinicaltrials.gov/ct2/show/NCT02064439 (first received 17 February 2014).
    1. Reduced-dosed rivaroxaban and standard-dosed rivaroxaban versus aspirin in the long-term prevention of blood clots from recurring in the leg or lung. explorer.opentrials.net/trials/cc5722b3-d0bc-4a7d-a9d1-35d8391aac9c 2014;(accessed 4 December 2016).
    1. Weitz JI, Bauersachs R, Beyer-Westendorf J, Bounameaux H, Brighton TA, Cohen AT, et al. Two doses of rivaroxaban versus aspirin for prevention of recurrent venous thromboembolism. Rationale for and design of the EINSTEIN CHOICE study. Thrombosis and Haemostasis 2015;114(3):645-50. [PMID: ] - PubMed
Evans 1975 {published data only}
    1. Evans G, Gent M. Effect of platelet suppressive drugs on arterial and venous thromboembolism. In: Cade JF, Hirsh J, Gallus AS, Schönbaum E, editors(s). Platelets, drugs and thrombosis. Basel: Karger, 1975:258-62. [DOI: 10.1159/000395715] - DOI
IRCT20200202046344N1 {published data only}
    1. IRCT20200202046344N1. Comparison of the effectiveness of aspirin with enoxaparin sodium for prevention of deep vein thrombosis in tibial fractures. en.irct.ir/trial/49703 (first received 29 September 2020).
Moriau 1982 {published data only}
    1. Moriau M, Col-De Beys C, Pardonge E, Ferrant A. Clinical and biological activity of the antiplatelet agent suloctidil in treatment of idiopathic recurrent vein thrombosis (I.R.V.T.). Thrombosis and Haemostasis 1982;47(1):27-31. [PMID: ] - PubMed
Nielsen 1994 {published data only}
    1. Nielsen HK, Husted SE, Krusell L, Fasting H, Charles P, Hansen HH, et al. Anticoagulant therapy in deep venous thrombosis. A randomized controlled study. Thrombosis and Haemostasis 1985;54(1):233. - PubMed
    1. Nielsen HK, Husted SE, Krusell LR, Fasting H, Charles P, Hansen HH, et al. Anticoagulant therapy in deep venous thrombosis. A randomized controlled study. Thrombosis Research 1994;73(3-4):215-26. [PMID: ] - PubMed
    1. Nielsen HK, Husted SE, Krusell LR, Fasting H, Charles P, Hansen HH. Silent pulmonary embolism in patients with deep venous thrombosis. Incidence and fate in a randomized, controlled trial of anticoagulation versus no anticoagulation. Journal of Internal Medicine 1994;235(5):457-61. [PMID: ] - PubMed
Sidhu 2019 {published data only}
    1. Sidhu VS, Graves SE, Buchbinder R, Naylor JM, Pratt NL, Steiger RS, et al. CRISTAL: protocol for a cluster randomised, crossover, non-inferiority trial of aspirin compared to low molecular weight heparin for venous thromboembolism prophylaxis in hip or knee arthroplasty, a registry nested study. BMJ Open 2019;9(11):e031657. [DOI: 10.1136/bmjopen-2019-031657] - DOI - PMC - PubMed
    1. Sidhu VS, Kelly TL, Pratt N, Graves S, Buchbinder R, Naylor J, et al. CRISTAL (a cluster-randomised, crossover, non-inferiority trial of aspirin compared to low molecular weight heparin for venous thromboembolism prophylaxis in hip or knee arthroplasty, a registry nested study): statistical analysis plan. Trials 2021;22(1):564. [DOI: 10.1186/s13063-021-05486-0] - DOI - PMC - PubMed

Additional references

Anderson 1991
    1. Anderson FA Jr, Wheeler HB, Goldberg RJ, Hosmer DW, Patwardhan NA, Jovanovic B, et al. A population-based perspective of the hospital incidence and case-fatality rates of deep vein thrombosis and pulmonary embolism. The Worcester DVT Study. Archives of Internal Medicine 1991;151(5):933-8. [PMID: ] - PubMed
Appelen 2017
    1. Appelen D, Loo E, Prins MH, Neumann MH, Kolbach DN. Compression therapy for prevention of post‐thrombotic syndrome. Cochrane Database of Systematic Reviews 2017, Issue 9. Art. No: CD004174. [DOI: 10.1002/14651858.CD004174.pub3] - DOI - PMC - PubMed
Autar 2006
    1. Autar R. Evidence for the prevention of venous thromboembolism. British Journal of Nursing 2006;15(18):980-6. [PMID: ] - PubMed
Avila 2022
    1. Ávila RB, Marcondes GB, Dias SV, Silveira BP, Amorim JE, Guedes HJ, et al. External validation of Villalta score in high-middle income country patients with deep vein thrombosis. Medicine 2022;101(24):e29367. [DOI: 10.1097/MD.0000000000029367] - DOI - PMC - PubMed
Becattini 2012
    1. Becattini C, Agnelli G, Schenone A, Eichinger S, Bucherini E, Silingardi M, et al. Aspirin for preventing the recurrence of venous thromboembolism. New England Journal of Medicine 2012;366(21):1959-67. [DOI: 10.1056/NEJMoa1114238] - DOI - PubMed
Belcaro 1993
    1. Belcaro G, Laurora G, Cesarone MR, De Sanctis MT. Prophylaxis of recurrent deep venous thrombosis. A randomized, prospective study using indobufen and graduated elastic compression stockings. Angiology 1993;44(9):695-9. [PMID: ] - PubMed
Boneu 1992
    1. Boneu B. Prevention of venous thrombosis with antiplatelet agents [Prevention des thromboses veineuses par les agents antiplaquettaires]. Annales Francaises d'Anesthesie et de Reanimation 1992;11(3):329. [PMID: ] - PubMed
Boutitie 2011
    1. Boutitie F, Pinede L, Schulman S, Agnelli G, Raskob G, Julian J, et al. Influence of preceding length of anticoagulant treatment and initial presentation of venous thromboembolism on risk of recurrence after stopping treatment: analysis of individual participants' data from seven trials. BMJ (Clinical Research ed.) 2011;342:d3036. [PMID: ] - PMC - PubMed
Brar 2011
    1. Brar SS, ten Berg J, Marcucci R, Price MJ, Valgimigli M, Kim HS, et al. Impact of platelet reactivity on clinical outcomes after percutaneous coronary intervention. A collaborative meta-analysis of individual participant data. Journal of the American College of Cardiology 2011;58(19):1945-54. [PMID: ] - PubMed
Braunwald 2012
    1. Braunwald E. The rise of cardiovascular medicine. European Heart Journal 2012;33(7):838-45, 845a. [PMID: ] - PMC - PubMed
Brighton 2012
    1. Brighton TA, Eikelboom JW, Mann K, Mister R, Gallus A, Ockelford P, et al. Low-dose aspirin for preventing recurrent venous thromboembolism. New England Journal of Medicine 2012;367(21):1979-87. [DOI: 10.1056/NEJMoa1210384] - DOI - PubMed
Broderick 2021
    1. Broderick C, Watson L, Armon MP. Thrombolytic strategies versus standard anticoagulation for acute deep vein thrombosis of the lower limb. Cochrane Database of Systematic Reviews 2021, Issue 1. Art. No: CD002783. [DOI: 10.1002/14651858.CD002783.pub5] - DOI - PMC - PubMed
Castellucci 2013
    1. Castellucci LA, Cameron C, Le Gal G, Rodger MA, Coyle D, Wells PS, et al. Efficacy and safety outcomes of oral anticoagulants and antiplatelet drugs in the secondary prevention of venous thromboembolism: systematic review and network meta-analysis. BMJ (Clinical research ed.) 2013;347:f5133. [PMID: ] - PMC - PubMed
Castro 2006
    1. Castro HC, Ferreira BL, Nagashima T, Schueler A, Rueff C, Camisasca D, et al. Platelets: still a therapeutical target [Plaquetas: ainda um alvo terapêutico]. Jornal Brasileiro de Patologia e Medicina Laboratorial 2006;42(5):321-32. [DOI: 10.1590/S1676-24442006000500004] - DOI
COVIDSurg 2022
    1. COVIDSurg Collaborative, GlobalSurg Collaborative. SARS-CoV-2 infection and venous thromboembolism after surgery: an international prospective cohort study. Anaesthesia 2022;77(1):28-39. [PMID: 10.1111/anae.15563] - DOI - PMC - PubMed
Deeks 2021
    1. Deeks JJ, Higgins JP, Altman DG, editor(s). Chapter 10: Analysing data and undertaking meta-analyses. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (updated February 2021). Cochrane, 2021. Available from training.cochrane.org/handbook.
de Wolf 2012
    1. Wolf MA, Wittens CH, Kahn SR. Incidence and risk factors of the post-thrombotic syndrome. Phlebology/Venous Forum of the Royal Society of Medicine 2012;27 Suppl 1:85-94. [PMID: ] - PubMed
El‐Atat 2011
    1. El-Atat F, Sarkar K, Kodali V, Karajgikar R, Jakkulla M, Mares A, et al. A randomized pilot trial for aggressive therapeutic approaches in aspirin-resistant patients undergoing percutaneous coronary intervention. Journal of Invasive Cardiology 2011;23(1):9-13. [PMID: ] - PubMed
Elbourne 2002
    1. Elbourne DR, Altman DG, Higgins JP, Curtin F, Worthington HV, Vail A. Meta-analyses involving cross-over trials: methodological issues. International Journal of Epidemiology 2002;31(1):140-9. [PMID: ] - PubMed
Falanga 1999
    1. Falanga A, Rickles FR. Pathophysiology of the thrombophilic state in the cancer patient. Seminars in Thrombosis and Hemostasis 1999;25(2):173-82. [PMID: ] - PubMed
Flumignan 2015
    1. Flumignan RL, Flumignan CD, Baptista-Silva JC. Angioplasty for deep venous thrombosis. Cochrane Database of Systematic Reviews 2015, Issue 1. Art. No: CD011468. [DOI: 10.1002/14651858.CD011468] - DOI - PMC - PubMed
Flumignan 2022
    1. Flumignan RL, Civile VT, Tinôco JD, Pascoal PI, Areias LL, Matar CF, et al. Anticoagulants for people hospitalised with COVID-19. Cochrane Database of Systematic Reviews 2022, Issue 3. Art. No: CD013739. [DOI: 10.1002/14651858.CD013739.pub2] - DOI - PMC - PubMed
Galanaud 2012
    1. Galanaud JP, Kahn SR, Khau Van Kien A, Laroche JP, Quere I. Epidemiology and management of isolated distal deep venous thrombosis [Thromboses veineuses profondes distales isolees des membres inferieurs: epidemiologie et prise en charge]. La Revue de Médecine Interne/fondee par la Societé nationale Française de Médecine Interne 2012;33(12):678-85. [PMID: ] - PubMed
Goldhaber 2012
    1. Goldhaber SZ. Venous thromboembolism: epidemiology and magnitude of the problem. Best Practice and Research. Clinical Haematology 2012;25(3):235-42. [PMID: ] - PubMed
Gomes 2004
    1. Gomes MP, Deitcher SR. Risk of venous thromboembolic disease associated with hormonal contraceptives and hormone replacement therapy: a clinical review. Archives of Internal Medicine 2004;164(18):1965-76. [PMID: ] - PubMed
GRADEpro GDT 2015 [Computer program]
    1. McMaster University (developed by Evidence Prime) GRADEpro GDT Guideline Development Tool. Version accessed 6 March 2018. Hamilton (OH): McMaster University (developed by Evidence Prime), 2015. Available at gradepro.org.
GRADE Working Group
    1. GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ (Clinical Research ed.) 2004;328(7454):1490-4. [PMID: ] - PMC - PubMed
Guanella 2013
    1. Guanella R. Post-thrombotic syndrome: the forgotten complication of venous thromboembolism [Syndrome post-thrombotique: la complication negligee de la maladie thromboembolique veineuse]. Revue Médicale Suisse 2013;9(372):321-5. [PMID: ] - PubMed
Handoll 2015
    1. Handoll HH, Langhorne P. In defence of reviews of small trials: underpinning the generation of evidence to inform practice. Cochrane Database of Systematic Reviews 2015;(11). [DOI: 10.1002/14651858.ED000106] - DOI - PMC - PubMed
Heit 2000
    1. Heit JA, Silverstein MD, Mohr DN, Petterson TM, O'Fallon WM, Melton LJ 3rd. Risk factors for deep vein thrombosis and pulmonary embolism: a population-based case-control study. Archives of Internal Medicine 2000;160(6):809-15. [PMID: ] - PubMed
Heit 2008
    1. Heit JA. The epidemiology of venous thromboembolism in the community. Arteriosclerosis, Thrombosis, and Vascular Biology 2008;28(3):370-2. [PMID: ] - PMC - PubMed
Higgins 2003
    1. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ (Clinical Research ed.) 2003;327(7414):557-60. [PMID: ] - PMC - PubMed
Higgins 2017
    1. Higgins JP, Altman DG, Sterne JA, editor(s). Chapter 8: Assessing risk of bias in included studies. In: Higgins JP, Churchill R, Chandler J, Cumpston MS, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.2.0 (updated June 2017). Cochrane, 2017. Available from www.training.cochrane.org/handbook/archive/v5.2.
Higgins 2021
    1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (updated February 2021). Cochrane, 2021. Available from training.cochrane.org/handbook. - PMC - PubMed
ISTH 2014
    1. ISTH Steering Committee for World Thrombosis Day. Thrombosis: a major contributor to global disease burden. Thrombosis and Haemostasis 2014;112(5):843-52. [PMID: ] - PubMed
Kakkos 2021
    1. Kakkos SK, Gohel M, Baekgaard N, Bauersachs R, Bellmunt-Montoya S, Black SA, et al. Editor's Choice - European Society for Vascular Surgery (ESVS) 2021 Clinical Practice Guidelines on the management of venous thrombosis. European Journal of Vacular and Endovascular Surgery 2021;61(1):9-82. [PMID: 10.1016/j.ejvs.2020.09.023] - DOI - PubMed
Lefebvre 2022
    1. Lefebvre C, Glanville J, Briscoe S, Littlewood A, Marshall C, Metzendorf M-I, et al. Chapter 4: Searching for and selecting studies. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (updated February 2021). Cochrane, 2021. Available from training.cochrane.org/handbook.
Liberati 2009
    1. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ 2009;339:b2700. [DOI: 10.1136/bmj.b2700] - DOI - PMC - PubMed
Lugo 2008
    1. Lugo JJ, Hurtado EF, Calderón LI, Gómez G, Castro P, Estrada G, et al. Resistance to acetylsalicylic acid and to clopidogrel: an emergent clinical entity [Resistencia al ácido acetil salicílico y al clopidogrel: una entidad clínica emergente]. Revista Colombiana de Cardiología 2008;15(4):172-83.
Marik 2015
    1. Marik PE, Cavallazzi R. Extended anticoagulant and aspirin treatment for the secondary prevention of thromboembolic disease: a systematic review and meta-analysis. PloS one 2015;10(11):e0143252. [PMID: ] - PMC - PubMed
Matielo 2008
    1. Matielo MF, Presti C, Casella IB, Netto BM, Puech-Leao P. Incidence of ipsilateral postoperative deep venous thrombosis in the amputated lower extremity of patients with peripheral obstructive arterial disease. Journal of Vascular Surgery 2008;48(6):1514-9. [PMID: ] - PubMed
Matzdorff 2005
    1. Matzdorff A. Platelet function tests and flow cytometry to monitor antiplatelet therapy. Seminars in Thrombosis and Hemostasis 2005;31(4):393-9. [PMID: ] - PubMed
McColl 1997
    1. McColl MD, Ramsay JE, Tait RC, Walker ID, McCall F, Conkie JA, et al. Risk factors for pregnancy associated venous thromboembolism. Thrombosis and Haemostasis 1997;78(4):1183-8. [PMID: ] - PubMed
Moher 2009
    1. Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ 2009;339:b2535. [DOI: 10.1136/bmj.b2535] - DOI - PMC - PubMed
Naess 2007
    1. Naess IA, Christiansen SC, Romundstad P, Cannegieter SC, Rosendaal FR, Hammerstrom J. Incidence and mortality of venous thrombosis: a population-based study. Journal of Thrombosis and Haemostasis 2007;5(4):692-9. [PMID: ] - PubMed
NICE 2020
    1. National Institute for Health and Care Excellence. Venous thromboembolic diseases: diagnosis, management and thrombophilia testing. Available from www.nice.org.uk/guidance/ng158 (accessed 29 March 2022).
Nicolaides 2001
    1. Nicolaides AN, Breddin HK, Fareed J, Goldhaber S, Haas S, Hull R, et al. Prevention of venous thromboembolism. International Consensus Statement. Guidelines compiled in accordance with the scientific evidence. International Angiology 2001;20(1):1-37. [PMID: ] - PubMed
Paikin 2011
    1. Paikin JS, Wright DS, Eikelboom JW. Effectiveness and safety of combined antiplatelet and anticoagulant therapy: a critical review of the evidence from randomized controlled trials. Blood Reviews 2011;25(3):123-9. [PMID: ] - PubMed
Review Manager 2020 [Computer program]
    1. Nordic Cochrane Centre, The Cochrane Collaboration Review Manager 5 (RevMan 5). Version 5.4. Copenhagen: Nordic Cochrane Centre, The Cochrane Collaboration, 2020.
Robertson 2015
    1. Robertson L, Kesteven P, McCaslin JE. Oral direct thrombin inhibitors or oral factor Xa inhibitors for the treatment of deep vein thrombosis. Cochrane Database of Systematic Reviews 2015, Issue 6. Art. No: CD010956. [DOI: 10.1002/14651858.CD010956.pub2] - DOI - PubMed
Robertson 2016
    1. Robertson L, McBride O, Burdess A. Pharmacomechanical thrombectomy for iliofemoral deep vein thrombosis. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No: CD011536. [DOI: 10.1002/14651858.CD011536.pub2] - DOI - PMC - PubMed
Rosendaal 2005
    1. Rosendaal FR. Venous thrombosis: the role of genes, environment, and behavior. Hematology/the Education Program of the American Society of Hematology. American Society of Hematology. Education Program 2005;2005(1):1-12. [PMID: ] - PubMed
Rossouw 2002
    1. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002;288(3):321-33. [PMID: ] - PubMed
Roth 2017
    1. Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, Regional, and National Burden of Cardiovascular Diseases for 10 Causes, 1990 to 2015. Journal of the American College of Cardiology 2017;70(1):1-25. [PMID: ] - PMC - PubMed
Samama 2000
    1. Samama MM. An epidemiologic study of risk factors for deep vein thrombosis in medical outpatients: the Sirius study. Archives of Internal Medicine 2000;160(22):3415-20. [PMID: ] - PubMed
Santos 2022
    1. Santos BC, Flumignan RL, Civile VT, Atallah AN, Nakano LC. Prophylactic anticoagulants for non-hospitalised people with COVID-19. Cochrane Database of Systematic Reviews 2022, Issue 4. Art. No: CD015102. [DOI: 10.1002/14651858.CD015102] - DOI - PMC - PubMed
Schror 2015
    1. Schror K. Aspirin and venous thromboses [Acetylsalicylsaure und venose Thrombosen]. Der Internist 2015;56(1):84-90. [PMID: ] - PubMed
Schulman 2005
    1. Schulman S, Kearon C. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. Journal of Thrombosis and Haemostasis 2005;3(4):692-4. [PMID: ] - PubMed
Schulman 2010
    1. Schulman S, Angeras U, Bergqvist D, Eriksson B, Lassen MR, Fisher W. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in surgical patients. Journal of Thrombosis and Haemostasis 2010;8(1):202-4. [PMID: ] - PubMed
Schünemann 2013
    1. Schünemann H, Brożek J, Guyatt G, Oxman A, editor(s). Handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach (updated October 2013). GRADE Working Group, 2013. Available from gdt.guidelinedevelopment.org/app/handbook/handbook.html.
Schünemann 2021
    1. Schünemann HJ, Vist GE, Higgins JP, Santesso N, Deeks JJ, Glasziou P, et al. Chapter 15: Interpreting results and drawing conclusions. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (updated February 2021). Cochrane, 2021. Available from training.cochrane.org/handbook.
Sevitt 1961
    1. Sevitt S, Gallagher N. Venous thrombosis and pulmonary embolism. A clinico-pathological study in injured and burned patients. British Journal of Surgery 1961;48:475-89. [PMID: ] - PubMed
Simes 2014
    1. Simes J, Becattini C, Agnelli G, Eikelboom JW, Kirby AC, Mister R, et al. Aspirin for the prevention of recurrent venous thromboembolism: the INSPIRE collaboration. Circulation 2014;130(13):1062-71. [PMID: ] - PubMed
Sobieraj 2015
    1. Sobieraj DM, Coleman CI, Pasupuleti V, Deshpande A, Kaw R, Hernandez AV. Comparative efficacy and safety of anticoagulants and aspirin for extended treatment of venous thromboembolism: a network meta-analysis. Thrombosis Research 2015;135(5):888-96. [PMID: ] - PubMed
Soosainathan 2013
    1. Soosainathan A, Moore HM, Gohel MS, Davies AH. Scoring systems for the post-thrombotic syndrome. Journal of Vascular Surgery 2013;57(1):254-61. [PMID: ] - PubMed
Stevens 2021
    1. Stevens SM, Woller SC, Kreuziger LB, Bounameaux H, Doerschug K, Geersing GJ, et al. Antithrombotic therapy for VTE disease: second update of the CHEST guideline and expert panel report. Chest 2021;160(6):e545-608. [DOI: 10.1016/j.chest.2021.07.055] - DOI - PubMed
Tagalakis 2013
    1. Tagalakis V, Patenaude V, Kahn SR, Suissa S. Incidence of and mortality from venous thromboembolism in a real-world population: the Q-VTE study cohort. American Journal of Medicine 2013;126(9):832.e13-21. [PMID: ] - PubMed
Tsai 2002
    1. Tsai AW, Cushman M, Rosamond WD, Heckbert SR, Polak JF, Folsom AR. Cardiovascular risk factors and venous thromboembolism incidence: the longitudinal investigation of thromboembolism etiology. Archives of Internal Medicine 2002;162(10):1182-9. [PMID: ] - PubMed
UN 2005
    1. United Nations. Consolidated list of products: whose consumption and/or sale have been banned, withdrawn, severely restricted or not approved by governments. Economic & Social Affairs 2005;(12):251.
Urwin 2000
    1. Urwin SC, Parker MJ, Griffiths R. General versus regional anaesthesia for hip fracture surgery: a meta-analysis of randomized trials. British Journal of Anaesthesia 2000;84(4):450-5. [PMID: ] - PubMed
Vedantham 2009
    1. Vedantham S, Grassi CJ, Ferral H, Patel NH, Thorpe PE, Antonacci VP, et al. Reporting standards for endovascular treatment of lower extremity deep vein thrombosis. Journal of Vascular and Interventional Radiology 2009;20(7 Suppl):S391-408. [PMID: ] - PubMed
Vieira‐de‐Abreu 2012
    1. Vieira-de-Abreu A, Campbell RA, Weyrich AS, Zimmerman GA. Platelets: versatile effector cells in hemostasis, inflammation, and the immune continuum. Seminars in Immunopathology 2012;34(1):5-30. [PMID: ] - PMC - PubMed
Watson 2008
    1. Watson HG, Chee YL. Aspirin and other antiplatelet drugs in the prevention of venous thromboembolism. Blood Reviews 2008;22(2):107-16. [PMID: ] - PubMed

References to other published versions of this review

Flumignan 2016
    1. Flumignan CD, Flumignan RL, Baptista-Silva JC. Antiplatelet agents for the treatment of deep venous thrombosis. Cochrane Database of Systematic Reviews 2016, Issue 9. Art. No: CD012369. [DOI: 10.1002/14651858.CD012369] - DOI - PMC - PubMed

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