Effect of Combined Anticoagulation and Low-Dose Aspirin Treatment on Upper Gastrointestinal Bleeding

摘要: Multiple studies link the use of nonsteroidal antiinflammatory drugs (NSAIDs) with severe upper gastrointestinal bleeding (UGIB); incidence such is 2-4%. One common regimen to assure patency after intracoronary stent placement requires an anticoagulant (warfarin) combined aspirin as antiplatelet agent. However, a 13-fold increase in risk UGIB occurs long-term oral anticoagulants and NSAIDs. We retrospectively assessed rate 138 patients who had received coronary stents (group I, receiving heparin followed by warfarin combination aspirin) 109 angioplasty without II, alone) between 1990 1994. was identified hematemesis or melena, which led consultation. Patients were analyzed for multiple factors. occurred 28 group I (20%; 95% CI 13.3-26.7%) 0 II (P < 0.0001). Esophagogastroduodenoscopy (EGD) findings on included 13 esophagitis gastritis, 7 gastric duodenal ulcers, 8 no identifiable source bleeding. within mean 2.5 days initiation therapy. Of UGIB, 10 required blood transfusion (mean number units = 5.3). Previous history peptic ulcer disease, smoking, antiulcer medication did not significantly differ two groups. The concurrent creates significant potential should be used only extreme caution.