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Comment & Response
March 6, 2019

Which Aspirin to Choose?

Author Affiliations
  • 1Department of Cardiology, Merate Hospital, Azienda Socio-Sanitaria Territoriale Lecco, Merate, Italy
  • 2Servizio Immunotrasfusionale, Azienda Socio-Sanitaria Territoriale Vimercate, Monza Brianza, Italy
JAMA Surg. 2019;154(6):565. doi:10.1001/jamasurg.2019.0112

To the Editor The article by Hood et al1 states that aspirin offers protection from postoperative venous thromboembolism following total knee arthroplasty that is not inferior to the protection provided by anticoagulants. To achieve efficacy, vitamin K antagonists are given according to the international normalized ratio value, while direct anticoagulants are usually given in fixed dosages. On the other hand, aspirin efficacy is more variable and is difficult to assess in the normal clinical routine. Enteric-coated vs non–enteric-coated tablets, differences in doses, and the influence of body weight all combine to affect the results,2,3 in addition to the unpredictable nonadherence of the patients.4 For these reasons, we would like to know more details of the kind of pharmaceutical formulation and dosages of aspirin that were used in the study by Hood et al.1

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