BMJ 1994;308:1371-2 (21 May)

Letters

Trails of antiplatelet therapy

Editor, - The impressive collaborative overview of antiplatelet therapy for prevention of venous thromboembolism1 raises several question which are of great practical relevance in daily practice. Firstly, this meta -analysis contradicts the recommendations given by consensus panels2 and also the general opinion of experts that aspirin has little or no effect on venous thrombosis or pulmonary embolism. Secondly, the authors studied 9000 randomised patients from 62 trials (only two published later than 1985); another systematic overview published five years ago found only five trials and 762 randomised patient and concluded that aspirin induces only a non -significant reduction in postoperative venous thrombosis.3 Thirdly, the goal of the Antiplatelet Trialists' Collaboration was to identify all randomised trials on the topic, rather than using predefined quality criteria to detect trials that have been planned, conducted, and analysed appropriately.

Fourthly, the introduction of the paper says that subcutaneous heparin is associated with a . . . [Full text of this article]


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