Upper GI risks of NSAIDs and antiplatelet agents: key issues for the cardiologist.
The use of antiplatelet/antithrombotic agents (eg, low-dose aspirin or clopidogrel) in primary or secondary intervention treatment strategies for cardiovascular disease is a common practice among cardiologists. Furthermore, these agents frequently are used concomitantly with other nonsteroidal anti-inflammatory drugs (NSAIDs) that patients are taking for a wide array of rheumatologic- or orthopedic-related complaints. These therapies, however, have defined upper gastrointestinal (UGI) risks for ulcer-related injury and complications. It is important for the cardiologist to fully understand the UGI risk profiles so that each patient is evaluated as a candidate for possible preventive co-therapy with appropriate anti-ulcer medication.
Johnson
David A
DA
Division of Gastroenterology, Eastern Virginia Medical School, Norfolk, Virginia, USA.
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D001241:Aspirin / Q000009:adverse effects; D002309:Cardiology; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000191:economics; D000077144:Clopidogrel; D004305:Dose-Response Relationship, Drug; D005343:Fibrinolytic Agents / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000191:economics / Q000382:microbiology / Q000517:prevention & control; D017048:Health Care Costs; D016481:Helicobacter Infections / Q000150:complications / Q000382:microbiology; D016480:Helicobacter pylori; D006801:Humans; D018579:Patient Selection; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D018570:Risk Assessment; D012307:Risk Factors; D013276:Stomach Ulcer / Q000139:chemically induced* / Q000191:economics / Q000382:microbiology / Q000517:prevention & control; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D005343:Fibrinolytic Agents; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin