[Aspirin and XXXX .]

@entity1 @entity548 @entity260 @entity1150 @entity715 @entity1211
BACKGROUND: The pharmacological prevention of @entity1211 ( @entity1211 ) has so far been carried out mainly with classic (low-molecular-weight heparins, coumarins) or new direct oral anticoagulants (DOACs). The role of antiplatelet treatment with aspirin is controversial. New data, however, suggest a paradigm shift with the reassessment of aspirin as part of a multimodal antithrombotic approach. OBJECTIVE: The article provides an up-to-date overview of the role of antiplatelet treatment with aspirin in the primary and secondary prevention of @entity1211 . CURRENT DATA AND RESULTS: Primary prevention of surgery-related @entity1211 with anticoagulants is effective but apparently not superior to a multimodal approach with aspirin, pneumatic compression, and early mobilization. Against this background, aspirin is now also included in the @entity1211 prevention guidelines in the US (ACCP, AAOS) but not in the UK (NICE) and Germany (AMWF). A final evaluation of aspirin as compared to classic anticoagulants and DOACs in primary prophylaxis requires further randomized controlled, prospective trials. These should also consider the iatrogenic risk of @entity548 as well as possible @entity260 , such as retarded wound healing that might require prolonged hospitalization. After ending guideline-conforming anticoagulant treatment in @entity1 with idiopathic @entity1211 , administration of aspirin reduces the risk of recurrent @entity1211 by about 40   % without increasing the risk of severe @entity548 (standardized INSPIRE evaluation of ASPIRE and WARFASA data). These data add to the current use of aspirin in the prevention of arterial @entity715 the new option of preventing spontaneous @entity1211 . CONCLUSION: On the basis of new data from recent studies, an indication can be made for the use of aspirin, combined with other preventive measures, in the prevention of primary and secondary @entity1150 .
