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Table of Contents
Vol. 77, No. 3-4, 2008
Issue release date: August 2008
Section title: Original Paper
Digestion 2008;77:173–177
(DOI:10.1159/000141264)

Upper Gastrointestinal Bleeding in Patients with Aspirin and Clopidogrel Co-Therapy

Ng F.-H.a · Lam K.-F.b · Wong S.-Y.a · Chang C.-M.a · Lau Y.-K.a · Yuen W.-C.a · Chu W.-M.a · Wong B.C.Y.c
aDepartment of Medicine and Surgery, Ruttonjee Hospital, bDepartment of Statistics and Actuarial Science, University of Hong Kong, and cDepartment of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, SAR, China

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: November 06, 2007
Accepted: August 01, 2008
Published online: June 25, 2008
Issue release date: August 2008

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 2

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG

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.

© 2008 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: November 06, 2007
Accepted: August 01, 2008
Published online: June 25, 2008
Issue release date: August 2008

Number of Print Pages: 5
Number of Figures: 0
Number of Tables: 2

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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