Etiology of gastrointestinal bleeding in patients on dual antiplatelet therapy

Etiology of gastrointestinal bleeding in patients on dual antiplatelet therapy INTRODUCTIONAspirin and clopidogrel significantly reduce the risk of myocardial infarction (MI), stroke, vascular events or cardiovascular death compared with placebo. According to the current American College of Cardiology (ACC)/American Heart Association (AHA) guidelines, dual antiplatelet therapy (DAPT) is recommended after percutaneous coronary and peripheral vascular interventions, MI and ischemic stroke.However, these benefits are offset to some degree by an increased risk of bleeding, especially gastrointestinal (GI) bleeding. Several large randomized cardiovascular trials have confirmed the association of DAPT with an increased risk of GI bleeding compared with aspirin therapy alone. In patients undergoing percutaneous coronary intervention, GI bleeding is a common cause of non‐access site bleeding and has been associated with increased inpatient morbidity and mortality.However, while a plethora of large‐scale studies show the incidence, predictors and prognosis of DAPT‐related GI bleeding, there is a relative paucity of evidence on the etiology of such bleeding. This is mostly because these large randomized studies were performed to assess the effect of DAPT on cardiovascular outcomes, and GI bleeding was only one out of a large number of events that were recorded. These studies did not report on the etiology of GI bleeding, just on their incidences and severity. The available http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Digestive Diseases Wiley

Etiology of gastrointestinal bleeding in patients on dual antiplatelet therapy

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd
ISSN
1751-2972
eISSN
1751-2980
D.O.I.
10.1111/1751-2980.12575
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONAspirin and clopidogrel significantly reduce the risk of myocardial infarction (MI), stroke, vascular events or cardiovascular death compared with placebo. According to the current American College of Cardiology (ACC)/American Heart Association (AHA) guidelines, dual antiplatelet therapy (DAPT) is recommended after percutaneous coronary and peripheral vascular interventions, MI and ischemic stroke.However, these benefits are offset to some degree by an increased risk of bleeding, especially gastrointestinal (GI) bleeding. Several large randomized cardiovascular trials have confirmed the association of DAPT with an increased risk of GI bleeding compared with aspirin therapy alone. In patients undergoing percutaneous coronary intervention, GI bleeding is a common cause of non‐access site bleeding and has been associated with increased inpatient morbidity and mortality.However, while a plethora of large‐scale studies show the incidence, predictors and prognosis of DAPT‐related GI bleeding, there is a relative paucity of evidence on the etiology of such bleeding. This is mostly because these large randomized studies were performed to assess the effect of DAPT on cardiovascular outcomes, and GI bleeding was only one out of a large number of events that were recorded. These studies did not report on the etiology of GI bleeding, just on their incidences and severity. The available

Journal

Journal of Digestive DiseasesWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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