Gut and Liver 2008; 2(2): 99-104 https://doi.org/10.5009/gnl.2008.2.2.99 Effect of Low-dose, Enteric Coated Aspirin on Gastrointestinal Bleeding in Patients with Coronary Artery Disease
Author Information
Chang Kyu Choi*, Nayoung Kim*,†, Jin Woo Choi*, Young Soo Park*,†, Jin-Wook Kim*, Sook-Hyang Jeong*, Dong Ho Lee*,†, Young-Seok Cho*,†, Tae-Jin Youn*,†, Woo-Young Chung*, In-Ho Chae*,†, and Dong-Ju Choi*,†
*Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Gyeonggi-do and Department of Internal Medicine, Seoul National University College of Medicine, Seongnam, Gyeonggi-do, Korea

Nayoung Kim
© The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. All rights reserved.

Abstract
Background/Aims: This study was performed to determine whether low-dose aspirin and/or clopidogrel can induce gastrointestinal bleeding and gastroduodenal mucosal injury. Methods: A total of 387 patients who underwent coronary angiography at Seoul National University Bundang Hospital were assigned to one of three antiplatelet treatment groups: (1) control, (2) 100-mg enteric coated aspirin, and (3) 100-mg enteric coated aspirin plus clopidogrel. The incidences of gastroduodenal mucosal injury and gastrointestinal bleeding were prospectively evaluated, and risk factors for gastrointestinal bleeding were analyzed. Results: The rate of gastroduodenal mucosal injury was higher in the aspirin-plus-clopidogrel group than in the aspirin group (p=0.012), and higher in the aspirin group than in the control group (p=0.049). The rate of gastrointestinal bleeding was significantly higher in the aspirin-plus-clopidogrel group (9.4%) than in the control group (2.4%, p=0.048). The risk factors for gastrointestinal bleeding were older age (≥60 years) and the presence of at least two comorbid disorders. Conclusions: Low-dose enteric coated aspirin was found to be safe in patients with coronary artery disease, but the addition of clopidogrel increased the rate of gastrointestinal bleeding. Combined clopidogrel and aspirin should be used with caution in older patients having at least two comorbid conditions. (Gut and Liver 2008;2:99-104)
Keywords: Aspirin; Clopidogrel; Gastroduodenal; Injury; Bleeding
Abstract
Background/Aims: This study was performed to determine whether low-dose aspirin and/or clopidogrel can induce gastrointestinal bleeding and gastroduodenal mucosal injury. Methods: A total of 387 patients who underwent coronary angiography at Seoul National University Bundang Hospital were assigned to one of three antiplatelet treatment groups: (1) control, (2) 100-mg enteric coated aspirin, and (3) 100-mg enteric coated aspirin plus clopidogrel. The incidences of gastroduodenal mucosal injury and gastrointestinal bleeding were prospectively evaluated, and risk factors for gastrointestinal bleeding were analyzed. Results: The rate of gastroduodenal mucosal injury was higher in the aspirin-plus-clopidogrel group than in the aspirin group (p=0.012), and higher in the aspirin group than in the control group (p=0.049). The rate of gastrointestinal bleeding was significantly higher in the aspirin-plus-clopidogrel group (9.4%) than in the control group (2.4%, p=0.048). The risk factors for gastrointestinal bleeding were older age (≥60 years) and the presence of at least two comorbid disorders. Conclusions: Low-dose enteric coated aspirin was found to be safe in patients with coronary artery disease, but the addition of clopidogrel increased the rate of gastrointestinal bleeding. Combined clopidogrel and aspirin should be used with caution in older patients having at least two comorbid conditions. (Gut and Liver 2008;2:99-104)
Keywords: Aspirin; Clopidogrel; Gastroduodenal; Injury; Bleeding
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