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Article: Upper gastrointestinal bleeding in patients with aspirin and clopidogrel co-therapy
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TitleUpper gastrointestinal bleeding in patients with aspirin and clopidogrel co-therapy
 
AuthorsNg, FH2
Lam, KF1
Wong, SY2
Chang, CM2
Lau, YK2
Yuen, WC2
Chu, WM2
Wong, BCY1
 
KeywordsAspirin
Clopidogrel
Gastrointestinal bleeding
Ischemic heart disease
Peptic ulcer
 
Issue Date2008
 
PublisherS Karger AG. The Journal's web site is located at http://www.karger.com/DIG
 
CitationDigestion, 2008, v. 77 n. 3-4, p. 173-177 [How to Cite?]
DOI: http://dx.doi.org/10.1159/000141264
 
AbstractIntroduction: The major complication of aspirin and clopidogrel (A+C) co-therapy is upper gastrointestinal bleeding (UGIB). However, data are unavailable for real-life situations. Furthermore, the treatment effect of antisecretory agents is unknown. Aim: This cohort study aimed to determine the occurrence of UGIB. The treatment effect of H2-receptor antagonist (H2RA) and proton pump inhibitor (PPI) was also analyzed. Method: The records of 987 consecutive patients on A+C co-therapy between January 2001 and September 2006 were analyzed. The follow-up ended on the dates of a first occurrence of UGIB, stopping A+C co-therapy, a change in the antisecretory class, death, or March 2007. Results: After a follow-up of 5.8 ± 6.5 months, UGIB occurred in 39 (4.0%) patients. PPI, H2RA and control were prescribed in 213, 287 and 487 patients respectively. After adjustment for age, dose of aspirin, previous UGIB and duration of treatment, the risk was marginally reduced by H2RA (OR = 0.43, 95% CI 0.18-0.91, p = 0.04) and significantly reduced by PPI (OR = 0.04, 95% CI 0.002-0.21, p = 0.002), as compared to control. Conclusion: The occurrence of UGIB associated with A+C co-therapy for a median of 5.8 months was 4.0%. Co-prescription with PPI was associated with a lower risk. Copyright © 2008 S. Karger AG.
 
ISSN0012-2823
2013 Impact Factor: 2.032
 
DOIhttp://dx.doi.org/10.1159/000141264
 
ISI Accession Number IDWOS:000258318000010
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorNg, FH
 
dc.contributor.authorLam, KF
 
dc.contributor.authorWong, SY
 
dc.contributor.authorChang, CM
 
dc.contributor.authorLau, YK
 
dc.contributor.authorYuen, WC
 
dc.contributor.authorChu, WM
 
dc.contributor.authorWong, BCY
 
dc.date.accessioned2010-09-06T07:23:43Z
 
dc.date.available2010-09-06T07:23:43Z
 
dc.date.issued2008
 
dc.description.abstractIntroduction: The major complication of aspirin and clopidogrel (A+C) co-therapy is upper gastrointestinal bleeding (UGIB). However, data are unavailable for real-life situations. Furthermore, the treatment effect of antisecretory agents is unknown. Aim: This cohort study aimed to determine the occurrence of UGIB. The treatment effect of H2-receptor antagonist (H2RA) and proton pump inhibitor (PPI) was also analyzed. Method: The records of 987 consecutive patients on A+C co-therapy between January 2001 and September 2006 were analyzed. The follow-up ended on the dates of a first occurrence of UGIB, stopping A+C co-therapy, a change in the antisecretory class, death, or March 2007. Results: After a follow-up of 5.8 ± 6.5 months, UGIB occurred in 39 (4.0%) patients. PPI, H2RA and control were prescribed in 213, 287 and 487 patients respectively. After adjustment for age, dose of aspirin, previous UGIB and duration of treatment, the risk was marginally reduced by H2RA (OR = 0.43, 95% CI 0.18-0.91, p = 0.04) and significantly reduced by PPI (OR = 0.04, 95% CI 0.002-0.21, p = 0.002), as compared to control. Conclusion: The occurrence of UGIB associated with A+C co-therapy for a median of 5.8 months was 4.0%. Co-prescription with PPI was associated with a lower risk. Copyright © 2008 S. Karger AG.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationDigestion, 2008, v. 77 n. 3-4, p. 173-177 [How to Cite?]
DOI: http://dx.doi.org/10.1159/000141264
 
dc.identifier.doihttp://dx.doi.org/10.1159/000141264
 
dc.identifier.epage177
 
dc.identifier.hkuros147585
 
dc.identifier.isiWOS:000258318000010
 
dc.identifier.issn0012-2823
2013 Impact Factor: 2.032
 
dc.identifier.issue3-4
 
dc.identifier.openurl
 
dc.identifier.pmid18577887
 
dc.identifier.scopuseid_2-s2.0-50149107595
 
dc.identifier.spage173
 
dc.identifier.urihttp://hdl.handle.net/10722/76673
 
dc.identifier.volume77
 
dc.languageeng
 
dc.publisherS Karger AG. The Journal's web site is located at http://www.karger.com/DIG
 
dc.publisher.placeSwitzerland
 
dc.relation.ispartofDigestion
 
dc.relation.referencesReferences in Scopus
 
dc.rightsDigestion. Copyright © S Karger AG.
 
dc.subject.meshAged
 
dc.subject.meshAged, 80 and over
 
dc.subject.meshAspirin - therapeutic use
 
dc.subject.meshCoronary Disease - drug therapy
 
dc.subject.meshDrug Therapy, Combination
 
dc.subject.meshFemale
 
dc.subject.meshGastrointestinal Hemorrhage - chemically induced
 
dc.subject.meshHumans
 
dc.subject.meshMale
 
dc.subject.meshMiddle Aged
 
dc.subject.meshMyocardial Ischemia - drug therapy
 
dc.subject.meshOdds Ratio
 
dc.subject.meshPlatelet Aggregation Inhibitors - therapeutic use
 
dc.subject.meshTiclopidine - analogs & derivatives - therapeutic use
 
dc.subjectAspirin
 
dc.subjectClopidogrel
 
dc.subjectGastrointestinal bleeding
 
dc.subjectIschemic heart disease
 
dc.subjectPeptic ulcer
 
dc.titleUpper gastrointestinal bleeding in patients with aspirin and clopidogrel co-therapy
 
dc.typeArticle
 
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<contributor.author>Lau, YK</contributor.author>
<contributor.author>Yuen, WC</contributor.author>
<contributor.author>Chu, WM</contributor.author>
<contributor.author>Wong, BCY</contributor.author>
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<description.abstract>Introduction: The major complication of aspirin and clopidogrel (A+C) co-therapy is upper gastrointestinal bleeding (UGIB). However, data are unavailable for real-life situations. Furthermore, the treatment effect of antisecretory agents is unknown. Aim: This cohort study aimed to determine the occurrence of UGIB. The treatment effect of H2-receptor antagonist (H2RA) and proton pump inhibitor (PPI) was also analyzed. Method: The records of 987 consecutive patients on A+C co-therapy between January 2001 and September 2006 were analyzed. The follow-up ended on the dates of a first occurrence of UGIB, stopping A+C co-therapy, a change in the antisecretory class, death, or March 2007. Results: After a follow-up of 5.8 &#177; 6.5 months, UGIB occurred in 39 (4.0%) patients. PPI, H2RA and control were prescribed in 213, 287 and 487 patients respectively. After adjustment for age, dose of aspirin, previous UGIB and duration of treatment, the risk was marginally reduced by H2RA (OR = 0.43, 95% CI 0.18-0.91, p = 0.04) and significantly reduced by PPI (OR = 0.04, 95% CI 0.002-0.21, p = 0.002), as compared to control. Conclusion: The occurrence of UGIB associated with A+C co-therapy for a median of 5.8 months was 4.0%. Co-prescription with PPI was associated with a lower risk. Copyright &#169; 2008 S. Karger AG.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong
  2. Ruttonjee Hospital Hong Kong