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Article: Upper gastrointestinal bleeding in patients with aspirin and clopidogrel co-therapy

TitleUpper gastrointestinal bleeding in patients with aspirin and clopidogrel co-therapy
Authors
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
Citation
Digestion, 2008, v. 77 n. 3-4, p. 173-177 How to Cite?
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 ± 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.
Persistent Identifierhttp://hdl.handle.net/10722/76673
ISSN
2013 Impact Factor: 2.032
ISI Accession Number ID
References

 

Author Affiliations
  1. The University of Hong Kong
  2. Ruttonjee Hospital Hong Kong
DC FieldValueLanguage
dc.contributor.authorNg, FHen_HK
dc.contributor.authorLam, KFen_HK
dc.contributor.authorWong, SYen_HK
dc.contributor.authorChang, CMen_HK
dc.contributor.authorLau, YKen_HK
dc.contributor.authorYuen, WCen_HK
dc.contributor.authorChu, WMen_HK
dc.contributor.authorWong, BCYen_HK
dc.date.accessioned2010-09-06T07:23:43Z-
dc.date.available2010-09-06T07:23:43Z-
dc.date.issued2008en_HK
dc.identifier.citationDigestion, 2008, v. 77 n. 3-4, p. 173-177en_HK
dc.identifier.issn0012-2823en_HK
dc.identifier.urihttp://hdl.handle.net/10722/76673-
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.en_HK
dc.languageengen_HK
dc.publisherS Karger AG. The Journal's web site is located at http://www.karger.com/DIGen_HK
dc.relation.ispartofDigestionen_HK
dc.rightsDigestion. Copyright © S Karger AG.en_HK
dc.subjectAspirinen_HK
dc.subjectClopidogrelen_HK
dc.subjectGastrointestinal bleedingen_HK
dc.subjectIschemic heart diseaseen_HK
dc.subjectPeptic ulceren_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAspirin - therapeutic useen_HK
dc.subject.meshCoronary Disease - drug therapyen_HK
dc.subject.meshDrug Therapy, Combinationen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshGastrointestinal Hemorrhage - chemically induceden_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMyocardial Ischemia - drug therapyen_HK
dc.subject.meshOdds Ratioen_HK
dc.subject.meshPlatelet Aggregation Inhibitors - therapeutic useen_HK
dc.subject.meshTiclopidine - analogs & derivatives - therapeutic useen_HK
dc.titleUpper gastrointestinal bleeding in patients with aspirin and clopidogrel co-therapyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0012-2823&volume=77&spage=173&epage=177&date=2008&atitle=Upper+Gastrointestinal+Bleeding+in+Patients+with+Aspirin+and+Clopidogrel+Co-therapyen_HK
dc.identifier.emailLam, KF: hrntlkf@hkucc.hku.hken_HK
dc.identifier.emailWong, BCY: bcywong@hku.hken_HK
dc.identifier.authorityLam, KF=rp00718en_HK
dc.identifier.authorityWong, BCY=rp00429en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1159/000141264en_HK
dc.identifier.pmid18577887en_HK
dc.identifier.scopuseid_2-s2.0-50149107595en_HK
dc.identifier.hkuros147585en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-50149107595&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume77en_HK
dc.identifier.issue3-4en_HK
dc.identifier.spage173en_HK
dc.identifier.epage177en_HK
dc.identifier.isiWOS:000258318000010-
dc.publisher.placeSwitzerlanden_HK
dc.identifier.scopusauthoridNg, FH=16936078000en_HK
dc.identifier.scopusauthoridLam, KF=8948421200en_HK
dc.identifier.scopusauthoridWong, SY=7404590845en_HK
dc.identifier.scopusauthoridChang, CM=20833817800en_HK
dc.identifier.scopusauthoridLau, YK=7201403303en_HK
dc.identifier.scopusauthoridYuen, WC=8608747200en_HK
dc.identifier.scopusauthoridChu, WM=23995209500en_HK
dc.identifier.scopusauthoridWong, BCY=7402023340en_HK

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