Arterial Thromboembolism and Prosthetic Heart Valves. Effects of Acetylsalicylic Acid

Prevention of arterial thromboembolism with acetylsalicylic acid (ASA) was studied double-blind in patients with aortic ball valve prostheses. Such patients have a high incidence of arterial emboli originating from thrombi formed on the valves, and the clinical effects of antithrombotic drugs can better be studied in this condition than in myocardial infarction, where the role of thrombosis is not definitely settled.

A total of 156 patients with single Starr-Edwards aortic ball valves received either one gm. of ASA daily or placebo in combination with warfarin, and were observed for two years. Only two emboli were diagnosed in patients taking ASA, none of them severe. In the placebo group 12 thromboembolic episodes occurred in 10 patients, and three with cerebral emboli died. Gastrointestinal complications were seen more frequently in patients receiving ASA, while two persons in each group suffered from intracranial bleeding. It was concluded that ASA combined with anticoagulants offered a significantly better protection against arterial thromboembolic complications than did anticoagulant therapy alone.

 

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