Adjuvant therapeutic efficacy of low-dose aspirin on short-term outcomes of patients with cancer-associated venous thromboembolism
Abstract Background Although aspirin was reported to have primary thromboprophylactic efficacy on cancer patients, its adjuvant role in the treatment of patients with cancer-associated venous thromboembolism (VTE) has been unclear yet. Methods Patients with cancer-associated VTE were retrospectively...
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2025-07-01
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| author | Wei Xiong Zhenzhong Deng Yi Cheng Xiaoyang Song Qihuan Yao Jianmin Qu Mei Xu Fengfeng Han Xuejun Guo Yong Luo |
| author_facet | Wei Xiong Zhenzhong Deng Yi Cheng Xiaoyang Song Qihuan Yao Jianmin Qu Mei Xu Fengfeng Han Xuejun Guo Yong Luo |
| author_sort | Wei Xiong |
| collection | DOAJ |
| description | Abstract Background Although aspirin was reported to have primary thromboprophylactic efficacy on cancer patients, its adjuvant role in the treatment of patients with cancer-associated venous thromboembolism (VTE) has been unclear yet. Methods Patients with cancer-associated VTE were retrospectively analyzed and divided into aspirin group and non-aspirin group based on whether they underwent low-dose aspirin (100 mg daily) in addition to conventional anticoagulants. Propensity score matching was used to balance baseline characteristics between the aspirin group and non-aspirin group in a 1:2 ratio. The primary, secondary, and tertiary outcomes were VTE recurrence, mortality and major bleeding, and net clinical benefit (NCB), at 6 months after VTE diagnosis, respectively. Results The VTE recurrence occurred in 13 (3.1%) in the aspirin group (N = 423) and 55 (6.5%) in the non-aspirin group (N = 846) (hazard ratio [HR] 0.546, 95% confidence interval [CI] [0.298–0.988], P = 0.011). The PE-related mortality occurred in 12 (2.8%) in the aspirin group and 46 (5.4%) in the non-aspirin group (HR 0.535, 95% CI [0.283–0.909], P = 0.037). The all-cause mortality occurred in 108 (25.5%) in the aspirin group and 228 (27.0%) in the non-aspirin group (HR 0.983, 95% CI [0.782–1.237], P = 0.887). The major bleeding occurred in 52 (12.3%) in the aspirin group and 46 (5.4%) in the non-aspirin group (HR 2.448, 95% CI [1.646–3.641], P < 0.001). The NCB occurred in 274 (64.8%) in the aspirin group and 554 (65.5%) in the non-aspirin group (HR 0.976, 95% CI [0.801–1.189], P = 0.812). Conclusions For patients with cancer-associated VTE, the adjuvant use of low-dose aspirin based on conventional anticoagulants improves VTE recurrence and PE-related mortality, compared with isolated use of anticoagulants, whereas it does not improve all-cause mortality or net clinical benefit. Adjuvant low-dose aspirin use is associated with an increased risk of bleeding. |
| format | Article |
| id | doaj-art-9c520462387c4bf19cd26e1fcce21e37 |
| institution | Kabale University |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
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| spelling | doaj-art-9c520462387c4bf19cd26e1fcce21e372025-08-20T03:45:49ZengBMCBMC Medicine1741-70152025-07-0123111010.1186/s12916-025-04284-8Adjuvant therapeutic efficacy of low-dose aspirin on short-term outcomes of patients with cancer-associated venous thromboembolismWei Xiong0Zhenzhong Deng1Yi Cheng2Xiaoyang Song3Qihuan Yao4Jianmin Qu5Mei Xu6Fengfeng Han7Xuejun Guo8Yong Luo9Department of Pulmonary and Critical Care Medicine, Xinhua Hospital, Shanghai Jiaotong University School of MedicineDepartment of Oncology, Xinhua Hospital, Shanghai Jiaotong University School of MedicineDepartment of Pulmonary and Critical Care Medicine, Xinhua Hospital, Shanghai Jiaotong University School of MedicineDepartment of Cardiovascular Medicine, Graduate School of Medicine, Kyoto UniversityDepartment of Traditional Chinese Medicine, Kongjiang Hospital, Yangpu DistrictDepartment of Critical Care Medicine, Tongxiang First People’s HospitalDepartment of General Practice, Bund Community Health Service Center, Hongkou DistrictDepartment of Pulmonary and Critical Care Medicine, Xinhua Hospital, Shanghai Jiaotong University School of MedicineDepartment of Pulmonary and Critical Care Medicine, Xinhua Hospital, Shanghai Jiaotong University School of MedicineDepartment of Pulmonary and Critical Care Medicine, Xinhua Hospital, Shanghai Jiaotong University School of MedicineAbstract Background Although aspirin was reported to have primary thromboprophylactic efficacy on cancer patients, its adjuvant role in the treatment of patients with cancer-associated venous thromboembolism (VTE) has been unclear yet. Methods Patients with cancer-associated VTE were retrospectively analyzed and divided into aspirin group and non-aspirin group based on whether they underwent low-dose aspirin (100 mg daily) in addition to conventional anticoagulants. Propensity score matching was used to balance baseline characteristics between the aspirin group and non-aspirin group in a 1:2 ratio. The primary, secondary, and tertiary outcomes were VTE recurrence, mortality and major bleeding, and net clinical benefit (NCB), at 6 months after VTE diagnosis, respectively. Results The VTE recurrence occurred in 13 (3.1%) in the aspirin group (N = 423) and 55 (6.5%) in the non-aspirin group (N = 846) (hazard ratio [HR] 0.546, 95% confidence interval [CI] [0.298–0.988], P = 0.011). The PE-related mortality occurred in 12 (2.8%) in the aspirin group and 46 (5.4%) in the non-aspirin group (HR 0.535, 95% CI [0.283–0.909], P = 0.037). The all-cause mortality occurred in 108 (25.5%) in the aspirin group and 228 (27.0%) in the non-aspirin group (HR 0.983, 95% CI [0.782–1.237], P = 0.887). The major bleeding occurred in 52 (12.3%) in the aspirin group and 46 (5.4%) in the non-aspirin group (HR 2.448, 95% CI [1.646–3.641], P < 0.001). The NCB occurred in 274 (64.8%) in the aspirin group and 554 (65.5%) in the non-aspirin group (HR 0.976, 95% CI [0.801–1.189], P = 0.812). Conclusions For patients with cancer-associated VTE, the adjuvant use of low-dose aspirin based on conventional anticoagulants improves VTE recurrence and PE-related mortality, compared with isolated use of anticoagulants, whereas it does not improve all-cause mortality or net clinical benefit. Adjuvant low-dose aspirin use is associated with an increased risk of bleeding.https://doi.org/10.1186/s12916-025-04284-8Venous thromboembolismCancerOutcomesAspirinAdjuvant |
| spellingShingle | Wei Xiong Zhenzhong Deng Yi Cheng Xiaoyang Song Qihuan Yao Jianmin Qu Mei Xu Fengfeng Han Xuejun Guo Yong Luo Adjuvant therapeutic efficacy of low-dose aspirin on short-term outcomes of patients with cancer-associated venous thromboembolism BMC Medicine Venous thromboembolism Cancer Outcomes Aspirin Adjuvant |
| title | Adjuvant therapeutic efficacy of low-dose aspirin on short-term outcomes of patients with cancer-associated venous thromboembolism |
| title_full | Adjuvant therapeutic efficacy of low-dose aspirin on short-term outcomes of patients with cancer-associated venous thromboembolism |
| title_fullStr | Adjuvant therapeutic efficacy of low-dose aspirin on short-term outcomes of patients with cancer-associated venous thromboembolism |
| title_full_unstemmed | Adjuvant therapeutic efficacy of low-dose aspirin on short-term outcomes of patients with cancer-associated venous thromboembolism |
| title_short | Adjuvant therapeutic efficacy of low-dose aspirin on short-term outcomes of patients with cancer-associated venous thromboembolism |
| title_sort | adjuvant therapeutic efficacy of low dose aspirin on short term outcomes of patients with cancer associated venous thromboembolism |
| topic | Venous thromboembolism Cancer Outcomes Aspirin Adjuvant |
| url | https://doi.org/10.1186/s12916-025-04284-8 |
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