Incidence of upper gastrointestinal bleeding and relevant factors associated with dual antiplatelet therapy in patients with coronary heart disease
10.3760/cma.j.issn.1671-0282.2011.11.018
- VernacularTitle:冠心病患者在双联抗血小板治疗过程中上消化道出血的发生率及影响因素
- Author:
Jun YANG
;
Feng LING
;
Zhaocai ZHANG
;
Yiyang DAI
;
Caiya ZHANG
- Publication Type:Journal Article
- Keywords:
Antiplatelet therapy;
Aspirin;
Clopidogrel;
Upper gastrointestinal bleeding
- From:
Chinese Journal of Emergency Medicine
2011;20(11):1183-1186
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the incidence and relevant factors of upper gastrointestinal bleeding(UGB)in patients with coronary heart disease(CHD)undergoing dual antiplatelet therapy(DAT)with aspirin plus clopidogrel.Methods A total of 391 CHD patients treated with aspirin plus clopidogrel (DAT group)and 502 control CHD patients receiving single antiplatelet therapy(SAT)with aspirin or clopidogrel(SAT group)were enrolled.The incidence and relevant factors associated with UGB were retrospectively analyzed in both groups of patients.Data were analyzed with Chi-square test and logistic regression by using SAS software version 9.0.Results The incidence of UGB in DAT group was significantly higher compared with SAT group(7.1％ vs.3.4％,P ＜ 0.01).The factors,including DAT,age over 65 years,medication duration over 3 months and previous digestive diseases increased the risk of UGB in CHD patients(P ＜ 0.05),while the use of PPIs(proton-pump inhibitors)or gastric mucosal protectives lowered the risk of UGB(OR:0.415,95％ CI 0.226 ～ 0.762,P =0.0035).Conclusions DAT can significantly increase the risk of UGB.UGB can be increased in elderly CHD patients and those with long-term medication and previous digestive diseases.Utility of PPIs or gastric mucosal protectives can effectively lower the incidence of UGB.
