Gut Liver.  2008 Sep;2(2):99-104.

Effect of Low-dose, Enteric Coated Aspirin on Gastrointestinal Bleeding in Patients with Coronary Artery Disease

• Choi CK
• Kim N
• Choi JW
• Park YS
• Kim JW
• Jeong SH
• Lee DH
• Cho YS
• Youn TJ
• Chung WY
• Chae IH
• Choi DJ

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 (> or =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.

Keyword

Aspirin; Clopidogrel; Gastroduodenal; Injury; Bleeding

MeSH Terms

Aspirin
Coronary Angiography
Coronary Artery Disease
Coronary Vessels
Hemorrhage
Humans
Incidence
Prospective Studies
Risk Factors
Ticlopidine
Aspirin
Ticlopidine