[Clinical impact of dual antiplatelet therapy on peptic ulcer disease]
| Autor: | Dae Geon Ahn, Jeong Wook Kim, Beom Jin Kim, Jae Gyu Kim |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Peptic Ulcer Ticlopidine medicine.drug_class Proton-pump inhibitor Coronary Artery Disease Coronary Angiography Gastroenterology Coronary artery disease Pharmacotherapy Risk Factors Internal medicine medicine Humans Aged Proportional Hazards Models Retrospective Studies Aspirin business.industry Incidence Hazard ratio Anti-Inflammatory Agents Non-Steroidal Proton Pump Inhibitors General Medicine Middle Aged Clopidogrel medicine.disease Platelet aggregation inhibitor Drug Therapy Combination Female Upper gastrointestinal bleeding business Gastrointestinal Hemorrhage Platelet Aggregation Inhibitors medicine.drug |
| Zdroj: | The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi. 64(2) |
| ISSN: | 2233-6869 |
| Popis: | Background/Aims: Increased incidence of coronary artery disease has led to the increased use of dual antiplatelet therapy composed of aspirin and clopidogrel. We investigated the incidence of gastrointestinal complications in patients who received single or dual antiplatelet therapy and analyzed their clinical characteristics in order to predict the prognostic factors. Methods: Between January 2009 and December 2011, we retrospectively reviewed the medical records of patients who underwent coronary angiography at Chung-Ang University Hospital (Seoul, Korea). One hundred and ninety-four patients were classified into two groups: aspirin alone group and dual antiplatelet group. Clinical characteristics, past medical history, and presence of peptic ulcer were analyzed. Results: During the follow-up period, 11 patients had duodenal ulcer; the event rate was 2.02% in the aspirin alone group and 9.47% in the dual antiplatelet group (hazard ratio [HR] 5.24, 95% CI 1.03-26.55, p＜0.05). There was no significant difference in the rate of significant upper gastrointestinal bleeding: 0% vs. 4.2% (p=0.78). In patients who received proton pump inhibitor (PPI), 24 patients had gastric ulcer; the event rate was significantly different between the two groups: 4.87% vs. 22.98% (HR 3.40, 95% CI 1.02-11.27, p＜0.05). Conclusions: Dual antiplatelet groups had a higher incidence of duodenal ulcers without significant bleeding compared with the aspirin alone group. In patients who received PPI, the dual antiplatelet therapy group had a higher incidence of gastric ulcers without significant bleeding compared with the aspirin alone group. Therefore, physicians must pay attention to high risk groups who receive dual antiplatelet therapy and aggressive diagnostic endoscopy should also be considered. (Korean J Gastroenterol 2014;64:81-86) |
| Databáze: | OpenAIRE |
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