| Titre : | Prevention of pulmonary embolism and deep vein thrombosis with low dose aspirin : Pulmonary embolism prevention (PEP) trial. (2000) |
| Auteurs : | Pulmonary Embolism Prevention Pep Trial Collaborative Group. INC |
| Type de document : | Article |
| Dans : | Lancet (The) (vol. 355, n° 9212, 2000) |
| Pagination : | 1295-1302 |
| Langues: | Anglais |
| Mots-clés : | Prévention santé ; Thrombose ; Etude comparée ; Essai double aveugle ; Prévention thérapeutique ; Chirurgie orthopédique ; Adulte ; Homme ; Suède ; Europe ; Nouvelle Zélande ; Océanie ; Afrique ; Royaume Uni ; Appareil respiratoire [pathologie] ; Chirurgie cardiovasculaire ; Appareil circulatoire [pathologie] ; Vaisseau sanguin [pathologie] ; Chirurgie ; République sud africaine |
| Résumé : | [BDSP. Notice produite par INIST BgGR0xYW. Diffusion soumise à autorisation]. Background Previous trials of antiplatelet therapy for the prevention of venous thromboembolism have individually been inconclusive, but a meta-analysis of their results indicated reductions in the risks of deep-vein thrombosis and of pulmonary embolism in various high-risk groups. The aim of this large randomised placebo-controlled trial was to confirm or refute these apparent benefits. Methods During 1992-1998,148 hospitals in Australia, New Zealand, South Africa, Sweden and the UK randomised 13 356 patients undergoing surgery for hip fracture, and 22 hospitals in New Zealand randomised a further 4088 patients undergoing elective arthroplasty. Study treatment was 160 mg daily aspirin or placebo, started preoperatively and continued for 35 days. Patients received any other thromboprophylaxis thought necessary. Follow-up was of mortality and of in-hospital morbidity up to day 35. Findings Among the patients with hip fracture, allocation to aspirin produced proportional reductions in pulmonary embolism of 43% (95% Cl 18-60 ; p=0.002) and in symptomatic deep-vein thrombosis of 29% (3-48 ; p=0.03). Pulmonary embolism or deep-vein thrombosis was confirmed in 105 (1.6%) of 6679 patients assigned aspirin compared with 165 (2.5%) of 6677 assigned placebo, which represents an absolute reduction of 9 (SE 2) per 1000 and a proportional reduction of 36% (19-50 ; p=0.0003). (...) |
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