6/28/23, 9:58 PM EPCAT I Pathway Feedback Search Clinical Topics Home Studies EPCAT I EPCAT I Disease Disease Hip fracture Hip osteoarthritis Trial question Is aspirin noninferior to dalteparin for extended VTE prophylaxis after total hip arthroplasty? Study design Multi-center Double blinded RCT Population Characteristics of study participants 43.4% female N = 786 56.6% male 786 patients (341 female, 444 male) Inclusion criteria: patients undergoing elective unilateral total hip arthroplasty who had an initial dalteparin prophylaxis for 10 days Key exclusion criteria: hip fracture in the previous 3 months, metastatic cancer, life expectancy < 6 months, major bleeding, active peptic ulcer disease or gastritis that precluded aspirin use, aspirin allergy, heparin-induced thrombocytopenia or heparin allergy Interventions N=386 aspirin (81 mg once daily for 28 days) N=400 dalteparin (5,000 U once daily for 28 days) Primary outcome Symptomatic venous thromboembolism 1.3 % 1.3 https://web.pathway.md/studies/recsOhcN1htgqSy4E 1/2 6/28/23, 9:58 PM EPCAT I Pathway 1.0 % 0.7 % Difference not exceeding nonferiority margin 0.3 % 0.3 0.0 % Aspirin Dalteparin Difference not exceeding nonferiority margin in symptomatic VTE (0.3% vs. 1.3%; AD 1%, 95% CI -0.5 to 2.5) Secondary outcomes No significant difference in major bleeding (AD 0.25%, 95% CI -4.9 to 1) No significant difference in VTE or clinically relevant bleeding (0.8% vs. 2.5%; AD 1.7%, 95% CI -0.3 to 3.8) No significant difference in clinically significant nonmajor bleeding (0.5% vs. 1%; AD 0.48%, 95% CI -1 to 2) Safety outcomes No significant differences in wound infections, arterial vascular events, deaths. Conclusion In patients undergoing elective unilateral total hip arthroplasty who had an initial dalteparin prophylaxis for 10 days, aspirin was noninferior to dalteparin with respect to symptomatic VTE. Reference Anderson DR, Dunbar MJ, Bohm ER et al. Aspirin versus low-molecular-weight heparin for extended venous thromboembolism prophylaxis after total hip arthroplasty: a randomized trial. Ann Intern Med. 2013 Jun 4;158(11):800-6. Open reference URL https://web.pathway.md/studies/recsOhcN1htgqSy4E 2/2