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
2011 Impact Factor: 2.046
2011 SCImago Journal Rankings: 0.157
DOIhttp://dx.doi.org/10.1159/000141264
ReferencesReferences in Scopus
DC Field
Value
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
2011 Impact Factor: 2.046
2011 SCImago Journal Rankings: 0.157
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
Author Affiliations
  1. The University of Hong Kong
  2. Ruttonjee Hospital Hong Kong