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Low-Molecular-Weight Heparin Is Superior to Aspirin in the Prevention of Thromboembolic Disease: Or Is It?

Published:November 06, 2022DOI:https://doi.org/10.1016/j.arth.2022.09.017
      A recent study published in the Journal of the American Medical Association, “Effect of Aspirin versus Enoxaparin on Symptomatic Venous Thromboembolism in Patients Undergoing Hip or Knee Arthroplasty: The CRISTAL Randomized Trial,” has again raised controversy concerning the optimal modality for venous thromboembolism (VTE) prophylaxis [
      • Sidhu V.S.
      • Kelly T.L.
      • Pratt N.
      • Graves S.E.
      • Buchbinder R.
      • Adie S.
      • et al.
      CRISTAL Study Group
      Effect of aspirin vs enoxaparin on symptomatic venous thromboembolism in patients undergoing hip or knee arthroplasty: the CRISTAL randomized trial.
      ]. The authors should be congratulated on completing this prospective, randomized, crossover, and registry-nested trial. This massive undertaking involved enrolling a large number of patients from 31 centers in Australia. The authors of the study reported that the incidence of symptomatic VTE was significantly higher in patients receiving aspirin (3.45%) compared with enoxaparin (1.82%).
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