Pulmonary Embolism Prevention trial (PEP)
13,000 randomised
To the surprise of many experts, CTSU's meta-analyses of antiplatelet trials indicated that not only did aspirin prevent occlusive arterial disease [25-27] but also it reduced the risk of venous thromboembolism following surgery [28]. The PEP trial, therefore, assessed the balance of benefits and risks of 162 mg daily aspirin (begun preoperatively and continued for 35 days) among patients with hip fracture, who are at substantial risk of pulmonary embolism and vascular complications.
PEP confirms the meta-analysis: among 13,356 randomised patients, aspirin produced a one-third reduction both in pulmonary embolism and in deep vein thrombosis [43], which is similar to the effects seen with subcutaneous heparin [44] (currently the most commonly used thromboprophylactic measure) but with less bleeding.
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