Article: High incidence of clopidogrel-associated gastrointestinal bleeding in patients with previous peptic ulcer disease

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TitleHigh incidence of clopidogrel-associated gastrointestinal bleeding in patients with previous peptic ulcer disease
AuthorsNg, FH2
Wong, SY2
Chang, CM2
Chen, WH1
Kng, C2
Lanas, AI3
Wong, BCY1
Issue Date2003
PublisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
CitationAlimentary Pharmacology And Therapeutics, 2003, v. 18 n. 4, p. 443-449 [How to Cite?]
DOI: http://dx.doi.org/10.1046/j.1365-2036.2003.01693.x
AbstractBackground: In average-risk patients, the new antiplatelet agent, clopidogrel, causes less upper gastrointestinal adverse events than aspirin. However, there are no safety data on the use of clopidogrel in high-risk patients. Aim: To evaluate the safety of clopidogrel in patients with peptic ulcer disease in a retrospective cohort longitudinal study. Methods: During the period from January 2000 to May 2002, 70 patients who were prescribed clopidogrel (75 mg/day) for a previous history of non-aspirin-related peptic ulcer disease or a history of aspirin-related gastrointestinal complications (dyspepsia or peptic ulcer) were recruited. The occurrence of ulcer complications (bleeding/perforation/obstruction) was the primary end-point. Results: After a median follow-up of 1 year, nine patients (12%) developed gastrointestinal bleeding and one had a perforated peptic ulcer. Clopidogrel-associated gastrointestinal bleeding was significantly more common in patients with a history of gastrointestinal bleeding than in those without (22% vs. 0%; P = 0.007: odds ratio, 1.3; 95% confidence interval, 1.1-1.5). Conclusions: Clopidogrel is associated with a high incidence of upper gastrointestinal bleeding in high-risk patients. A previous history of gastrointestinal bleeding appears to be a predictor of adverse gastrointestinal events.
ISSN0269-2813
2011 Impact Factor: 3.769
2011 SCImago Journal Rankings: 0.338
DOIhttp://dx.doi.org/10.1046/j.1365-2036.2003.01693.x
ISI Accession Number IDWOS:000185103200010
ReferencesReferences in Scopus
DC Field
Value
dc.contributor.authorNg, FH
dc.contributor.authorWong, SY
dc.contributor.authorChang, CM
dc.contributor.authorChen, WH
dc.contributor.authorKng, C
dc.contributor.authorLanas, AI
dc.contributor.authorWong, BCY
dc.date.accessioned2010-09-06T07:29:44Z
dc.date.available2010-09-06T07:29:44Z
dc.date.issued2003
dc.description.abstractBackground: In average-risk patients, the new antiplatelet agent, clopidogrel, causes less upper gastrointestinal adverse events than aspirin. However, there are no safety data on the use of clopidogrel in high-risk patients. Aim: To evaluate the safety of clopidogrel in patients with peptic ulcer disease in a retrospective cohort longitudinal study. Methods: During the period from January 2000 to May 2002, 70 patients who were prescribed clopidogrel (75 mg/day) for a previous history of non-aspirin-related peptic ulcer disease or a history of aspirin-related gastrointestinal complications (dyspepsia or peptic ulcer) were recruited. The occurrence of ulcer complications (bleeding/perforation/obstruction) was the primary end-point. Results: After a median follow-up of 1 year, nine patients (12%) developed gastrointestinal bleeding and one had a perforated peptic ulcer. Clopidogrel-associated gastrointestinal bleeding was significantly more common in patients with a history of gastrointestinal bleeding than in those without (22% vs. 0%; P = 0.007: odds ratio, 1.3; 95% confidence interval, 1.1-1.5). Conclusions: Clopidogrel is associated with a high incidence of upper gastrointestinal bleeding in high-risk patients. A previous history of gastrointestinal bleeding appears to be a predictor of adverse gastrointestinal events.
dc.description.natureLink_to_subscribed_fulltext
dc.identifier.citationAlimentary Pharmacology And Therapeutics, 2003, v. 18 n. 4, p. 443-449 [How to Cite?]
DOI: http://dx.doi.org/10.1046/j.1365-2036.2003.01693.x
dc.identifier.doihttp://dx.doi.org/10.1046/j.1365-2036.2003.01693.x
dc.identifier.epage449
dc.identifier.hkuros86484
dc.identifier.isiWOS:000185103200010
dc.identifier.issn0269-2813
2011 Impact Factor: 3.769
2011 SCImago Journal Rankings: 0.338
dc.identifier.issue4
dc.identifier.openurl
dc.identifier.pmid12940930
dc.identifier.scopuseid_2-s2.0-0042830369
dc.identifier.spage443
dc.identifier.urihttp://hdl.handle.net/10722/77236
dc.identifier.volume18
dc.languageeng
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/APT
dc.publisher.placeUnited Kingdom
dc.relation.ispartofAlimentary Pharmacology and Therapeutics
dc.relation.referencesReferences in Scopus
dc.rightsAlimentary Pharmacology and Therapeutics. Copyright © Blackwell Publishing Ltd.
dc.subject.meshAged
dc.subject.meshAspirin - adverse effects
dc.subject.meshCohort Studies
dc.subject.meshFemale
dc.subject.meshFollow-Up Studies
dc.subject.meshGastrointestinal Hemorrhage - chemically induced
dc.subject.meshHumans
dc.subject.meshLongitudinal Studies
dc.subject.meshMale
dc.subject.meshPeptic Ulcer - complications - drug therapy
dc.subject.meshPlatelet Aggregation Inhibitors - adverse effects
dc.subject.meshRecurrence
dc.subject.meshRetrospective Studies
dc.subject.meshRisk Factors
dc.subject.meshTiclopidine - adverse effects - analogs & derivatives
dc.titleHigh incidence of clopidogrel-associated gastrointestinal bleeding in patients with previous peptic ulcer disease
dc.typeArticle
Author Affiliations
  1. The University of Hong Kong
  2. Ruttonjee Hospital Hong Kong
  3. Hospital Clinico Universitario Lozano Blesa