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Conference Paper: Prevalence and prediction of gastrointestinal events in patients receiving a combination of aspirin plus clopidogrel

TitlePrevalence and prediction of gastrointestinal events in patients receiving a combination of aspirin plus clopidogrel
Authors
Issue Date2007
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro
Citation
Digestive Disease Week and the 108th Annual Meeting of the American Gastroenterological Association Institute, Washington, DC, 19-24 May 2007. In Gastroenterology, 2007, v. 132 n. 4, p. A-135 Abstract no. 916 How to Cite?
AbstractIntroduction: The efficacy of the addition of clopidogrel to aspirin has been established but this was associated with gastrointestinal complications in 1.3% of patients in study situation. However, this has not been documented in real life. Aim: This retrospective study aimed to determine the prevalence of upper gastrointestinal complication in real life situation. The treatment effect of H2-receptor antagonist (H2RA) and proton pump inhibitor (PPI) was also analysed, as compared to the control. Method: From Jan 2002 to Sept 2005, records of all patients receiving dual anti-platelet therapy were analysed. The end-point was the occurrence of symptomatic peptic ulcers or its complications. The last date of censor was 15 June 2006. Results: The patient group consisted of 664 patients (age 66.6±12.0 years). Prophylactic H2RA and PPI was prescribed to 148 (22.2%) and 160(24.1%) patients, respectively. Prior gastrointestinal bleeding was significantly more common in the PPI group (16.3%) or the H2RA group (4.1%) than the control group (2.0%). After a follow-up of 4.6±5.2 months, end-point was reached in 28 (4.2%) patients (gastrointestinal bleed 26, dyspepsia 2). After adjustment for the confounding covariates, the hazard ratio (95% confidence interval) for primary end-point was 0.053 (0.006-0.219) for PPI and 0.324 (0.113- 0.925) for H2RA, as compared to control. Conclusion: In real life, the incidence of peptic ulcer disease and gastrointestinal bleeding associated with dual aspirin plus clopdiogrel therapy was 4.2%. Co-prescription with PPI or H2RA can significantly reduce the risk. Hazard ratio (95% confidence interval) for primary and secondary end points : control, H2- receptor antagonist and proton pump inhibitor.
Persistent Identifierhttp://hdl.handle.net/10722/102986
ISSN
2015 Impact Factor: 18.187
2015 SCImago Journal Rankings: 7.170

 

DC FieldValueLanguage
dc.contributor.authorChan, AOOen_HK
dc.contributor.authorNg, FHen_HK
dc.contributor.authorChang, PCMen_HK
dc.contributor.authorWong, SYen_HK
dc.contributor.authorChu, WMen_HK
dc.contributor.authorYuen, WCen_HK
dc.contributor.authorLau, YKen_HK
dc.contributor.authorCheung, TKen_HK
dc.contributor.authorWong, BCYen_HK
dc.date.accessioned2010-09-25T20:52:55Z-
dc.date.available2010-09-25T20:52:55Z-
dc.date.issued2007en_HK
dc.identifier.citationDigestive Disease Week and the 108th Annual Meeting of the American Gastroenterological Association Institute, Washington, DC, 19-24 May 2007. In Gastroenterology, 2007, v. 132 n. 4, p. A-135 Abstract no. 916en_HK
dc.identifier.issn0016-5085en_HK
dc.identifier.urihttp://hdl.handle.net/10722/102986-
dc.description.abstractIntroduction: The efficacy of the addition of clopidogrel to aspirin has been established but this was associated with gastrointestinal complications in 1.3% of patients in study situation. However, this has not been documented in real life. Aim: This retrospective study aimed to determine the prevalence of upper gastrointestinal complication in real life situation. The treatment effect of H2-receptor antagonist (H2RA) and proton pump inhibitor (PPI) was also analysed, as compared to the control. Method: From Jan 2002 to Sept 2005, records of all patients receiving dual anti-platelet therapy were analysed. The end-point was the occurrence of symptomatic peptic ulcers or its complications. The last date of censor was 15 June 2006. Results: The patient group consisted of 664 patients (age 66.6±12.0 years). Prophylactic H2RA and PPI was prescribed to 148 (22.2%) and 160(24.1%) patients, respectively. Prior gastrointestinal bleeding was significantly more common in the PPI group (16.3%) or the H2RA group (4.1%) than the control group (2.0%). After a follow-up of 4.6±5.2 months, end-point was reached in 28 (4.2%) patients (gastrointestinal bleed 26, dyspepsia 2). After adjustment for the confounding covariates, the hazard ratio (95% confidence interval) for primary end-point was 0.053 (0.006-0.219) for PPI and 0.324 (0.113- 0.925) for H2RA, as compared to control. Conclusion: In real life, the incidence of peptic ulcer disease and gastrointestinal bleeding associated with dual aspirin plus clopdiogrel therapy was 4.2%. Co-prescription with PPI or H2RA can significantly reduce the risk. Hazard ratio (95% confidence interval) for primary and secondary end points : control, H2- receptor antagonist and proton pump inhibitor.-
dc.languageengen_HK
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastroen_HK
dc.relation.ispartofGastroenterologyen_HK
dc.titlePrevalence and prediction of gastrointestinal events in patients receiving a combination of aspirin plus clopidogrelen_HK
dc.typeConference_Paperen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0016-5085&volume=132&issue=4&spage=A135&epage=&date=2007&atitle=Prevalence+and+prediction+of+gastrointestinal+events+in+patients+receiving+a+combination+of+aspirin+plus+clopidogrel.++Digestive+Disease+Week+2007,+Washington+DC,+USA,+19-24+Mayen_HK
dc.identifier.emailChan, AOO: aoochan@hku.hken_HK
dc.identifier.emailNg, FH: ngfhong@HKUCC.hku.hken_HK
dc.identifier.emailChang, PCM: changcm@ha.org.hken_HK
dc.identifier.emailWong, SY: maggie10_18@yahoo.comen_HK
dc.identifier.emailLau, YK: yklau@ha.org.hken_HK
dc.identifier.emailCheung, TK: cheungtingkin@yahoo.comen_HK
dc.identifier.emailWong, BCY: bcywong@hku.hken_HK
dc.identifier.authorityWong, BCY=rp00429en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0016-5085(07)60009-2-
dc.identifier.hkuros131415en_HK
dc.identifier.volume132en_HK
dc.identifier.issue4en_HK
dc.identifier.spage135en_HK

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