BACKGROUND/AIMS: We conducted this study to find the clinical characteristics of ulcer bleeding that occurred in patients who had been taking non-steroidal anti-inflammatory drugs (NSAIDs) and to evaluate the influences of NSAIDs on clinical outcomes. METHODS: Between January 2000 and December 2002, a total of 310 patients with ulcer bleeding were analyzed. Study group composed of 49 patients who had taken NSAIDs regularly for at least 4 weeks before the admission. Other 261 patients who had not taken NSAIDs were classified as control group. Relevant informations were obtained from the medical records. RESULTS: Of the NSAIDs group, aspirin was the most common medication. The mean age and the proportion of females in the NSAIDs group were significantly higher than those of the control group. Prevalence of co-morbid illness was significantly higher in the NSAIDs group than in the control group (85.7% vs 30.7%, p<0.001). The severity of bleeding which was assessed by hemoglobin level at presentation, amount of transfusion, and duration of admission, was not different between two groups. There were no significant differences in frequency of re-bleeding, urgent surgery, and mortality. CONCLUSIONS: Ulcer bleeding among patients taking NSAIDs occurred more frequently in older females with co- morbid illness. However, NSAIDs is not associated with higher morbidity and mortality.
Aged ; Aged, 80 and over ; Anti-Inflammatory Agents, Non-Steroidal/*adverse effects/therapeutic use ; English Abstract ; Female ; Humans ; Male ; Middle Aged ; Peptic Ulcer Hemorrhage/*chemically induced/complications

BACKGROUND/AIMS: The increasing incidence of cardiovascular disease has led to an increase in the frequency of upper gastrointestinal (GI) hemorrhage due to the use of antiplatelet agents. This study examined the clinical characteristics of patients with upper GI hemorrhage who were administered aspirin alone or a combination treatment of antiplatelet agents. METHODS: A 656 patients who underwent drug-eluting coronary stenting at Ewha Mokdong Hospital in 2008 were divided into three groups according to the antiplatetlet agents used after the intervention; groups of aspirin alone, aspirin plus clopidogrel, and aspirin, and clopidogrel plus another antiplatelet agent, respectively. Patients admitted with GI hemorrhage in the same period without a medication history of antiplatelet or nonsteroidal anti-inflammatory drugs were used as the control hemorrhage group. The medical records were reviewed. RESULTS: Significant GI symptoms were observed in 21.1% of total patients, of whom 48.2% had ulcers. The upper GI hemorrhage rate was 3.8%. There was no significant difference in the hemorrhage rate between three groups. Compared to the control hemorrhage group, the endoscopic variables of the antiplatelet-related hemorrhage group were not significantly different. However, the Helicobacter pylori infection rate was lower, the admission period was longer, and the mortality rate was higher in the antiplatelet-related hemorrhage group (p<0.05, respectively). There was no direct association between restarting or discontinuance of antiplatelets after the hemorrhage event and mortality. CONCLUSIONS: Adding other antiplatelet agents to aspirin did not increase the hemorrhage rate. However, active diagnostic and therapeutic efforts are recommended in patients with GI symptoms during antiplatelet therapy.
Aged ; Aspirin/*adverse effects/therapeutic use ; Cardiovascular Diseases/prevention & control ; Drug Therapy, Combination ; Drug-Eluting Stents ; Endoscopy, Gastrointestinal ; Female ; Gastrointestinal Hemorrhage/*chemically induced/mortality/prevention & control ; Helicobacter Infections/complications/epidemiology ; Helicobacter pylori ; Humans ; Male ; Middle Aged ; Peptic Ulcer/complications/epidemiology ; Platelet Aggregation Inhibitors/*adverse effects/therapeutic use ; Retrospective Studies ; Risk Factors ; Ticlopidine/adverse effects/analogs & derivatives/therapeutic use