Management of upper gastrointestinal haemorrhage complicating dual anti-platelet therapy.
Upper gastrointestinal haemorrhage is a serious complication of aspirin and clopidogrel (dual) anti-platelet therapy with a high morbidity and mortality. Using an illustrative case this article examines the prognostic significance of gastrointestinal haemorrhage and the risk of stopping anti-platelet therapy. The management of this clinical challenge is reviewed, in the absence of a clinical guideline, with particular reference to the judicious tailoring of anti-platelet therapy, the role of therapeutic endoscopy and the utility of blood transfusion.
Henriksen
Peter A
PA
Department of Cardiology, Western General Hospital, Edinburgh, EH42XY, UK. p.henriksen@blueyonder.co.uk
Palmer
Kelvin
K
Boon
Nick A
NA
D000368:Aged; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D001803:Blood Transfusion; D000077144:Clopidogrel; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy; D004359:Drug Therapy, Combination; D016099:Endoscopy, Gastrointestinal / Q000379:methods; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced* / Q000517:prevention & control; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D010976:Platelet Count; D016032:Randomized Controlled Trials as Topic; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin