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Titolo:
EFFECT OF COMBINED ANTICOAGULATION AND LOW-DOSE ASPIRIN TREATMENT ON UPPER GASTROINTESTINAL-BLEEDING
Autore:
YOUNOSSI ZM; STRUM WB; SCHATZ RA; TEIRSTEIN PS; CLOUTIER DA; SPINKS TJ;
Indirizzi:
CLEVELAND CLIN FDN,DEPT GASTROENTEROL,DESK S-40,9500 EUCLID AVE CLEVELAND OH 44195 SCRIPPS CLIN,DIV GASTROENTEROL LA JOLLA CA 92037 SCRIPPS CLIN,DIV CARDIOVASC DIS LA JOLLA CA 92037 SCRIPPS CLIN,GEN CLIN RES CTR LA JOLLA CA 92037
Titolo Testata:
Digestive diseases and sciences
fascicolo: 1, volume: 42, anno: 1997,
pagine: 79 - 82
SICI:
0163-2116(1997)42:1<79:EOCAAL>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
NONSTEROIDAL ANTIINFLAMMATORY DRUGS; MUCOSAL INJURY; PEPTIC-ULCER; THERAPY;
Keywords:
NSAIDS; UPPER GASTROINTESTINAL BLEEDING; ANTICOAGULATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
25
Recensione:
Indirizzi per estratti:
Citazione:
Z.M. Younossi et al., "EFFECT OF COMBINED ANTICOAGULATION AND LOW-DOSE ASPIRIN TREATMENT ON UPPER GASTROINTESTINAL-BLEEDING", Digestive diseases and sciences, 42(1), 1997, pp. 79-82

Abstract

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

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/12/20 alle ore 16:04:15