Upper gastrointestinal haemorrhage complicating antiplatelet treatment with aspirin and/or clopidogrel: Where we are now?
Φόρτωση...
Ημερομηνία
Συγγραφείς
Liberopoulos, E. N.
Elisaf, M. S.
Tselepis, A. D.
Archimandritis, A.
Kiskinis, D.
Cokkinos, D.
Mikhailidis, D. P.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Platelets
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
A large number of patients require antiplatelet therapy (mainly aspirin and/or clopidogrel). Recent studies suggest that the combination of these agents is useful in patients with acute coronary syndrome and after percutaneous coronary intervention with stent placement. On the other hand, bleeding complications, most of which arise from the upper gastrointestinal (UGI) tract, can limit the use of antiplatelet drugs. Clopidogrel appears to be associated with fewer UGI side effects and bleeding compared with aspirin. However, a history of previous UGI bleeding is a major risk factor for clopidogrel-associated bleeding. The use of proton-pump inhibitors (PPIs) decreases the rate of UGI bleeding in patients receiving aspirin or clopidogrel. Furthermore, a recent study suggested that the administration of low-dose aspirin plus high-dose esomeprazole (a potent PPI) was associated with fewer episodes of UGI bleeding than clopidogrel alone in patients with a history of recent UGI haemorrhage. However, this study had several limitations and its results should be cautiously extrapolated into clinical practice. The combination of aspirin plus clopidogrel increases the risk of UGI bleeding. Unfortunately, there are no data on the effect of PPI prophylaxis in this setting. Available evidence suggests that where aspirin and/or clopidogrel are to be started or continued in patients with a recent history of UGI ulceration or bleeding (after ulcer healing and eradication of H. pylori infection), treatment with a PPI is a useful precaution. The patients should also be carefully monitored for recurrence of UGI bleeding.
Περιγραφή
Λέξεις-κλειδιά
aspirin, clopidogrel, coronary heart disease, gastrointestinal bleeding, stroke, peptic ulcer, proton pump inhibitor, acute coronary syndromes, st-segment elevation, low-dose aspirin, nonsteroidal antiinflammatory drugs, helicobacter-pylori infection, randomized controlled-trial, pump inhibitor therapy, peptic-ulcer disease, high-risk patients, myocardial-infarction
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
<Go to ISI>://000233578500001
http://informahealthcare.com/doi/abs/10.1080/09537100500237004
http://informahealthcare.com/doi/abs/10.1080/09537100500237004
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Θετικών Επιστημών. Τμήμα Χημείας