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A double-blind study has been performed in patients with aortic ball valves in order to study the antithrombotic effects of one gm of acetyl-salicylic acid (ASA) daily combined with anticoagulants, as compared with that of anticoagulants alone. The combined treatment offered a significantly better protection, the incidence in the two groups being 1.8 and 9·3 arterial thromboembolic complications per 100 patients per year, respectively. Encouraged by these results, a pilot study on the effects of ASA alone was started in 77 patients from both groupa of the first study. They all received one gm of ASA daily, then the dose of anticoagulants was reduced gradually and the drug discontinued on average five weeks later. Six arterial thromboembolic episodes occurred in five patients during the following five months, the incidence being 14.5 complications per 100 patients per year. The study was therefore ended, and anticoagulant therapy re-instituted in addition to ASA. The results indicate that combined treatment with ASA and anticoagulants more effectively inhibits arterial thrombus formation than does each of the drugs alone.

Prevention of Arterial Thromboembolism with Acetylsalicylic Acid in Patients with Prosthetic Heart Valves